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A 


PLAIN  AND  PRACTICAL  TREATISE 

ON  THE 

EPIDEMIC  CHOLERA, 

AS  IT  PREVAILED  IN  THE  CITY  OF  NEW  YORK, 
IN  THE  SUxMxMER  OF  183-2; 
INCLUDING  ITJi  NATURE,  CAUSE!^,  TREATMENT  AND  PREVENTION. 

DESIGNED  FOR  POPULAR  INSTRUCTION. 

TO  WHICH  13  ADDED,        WAY  OF  APPENDIX, 

A  BRIEF  ESSAY  ON  THE 

MEDICAL  USE  OF  ARDENT  SPIRITS; 

AN    ATTEMTT    TO   SHOW   THAT    ALCOHOL    IS   AS  UNNECESSARY 
AND    MISCHIEVOUS   IN    SICKNESS  AS   IN  HEALTH. 


BY  DAVID  MEREDITH  REESE,  M.  D. 


CONNER  &.  COOKE,  FRANKLIN  BUILDINGS; 

J.  &  J.  Harper ;  McElratli,  Banes,  &  Herbert ;  and  Collins  &  Hannaj-— Bos?o«  .*  Lilly,  Wait, 
&  Co.— Albany :  O.  Steel— Rochester :  Hoyt,  Porter.  Si  Co —Ithaca :  Mack  &  Andrus— L7ica  .• 
Wil!iam  Williams— B?/#a/o ;  R.  W.  Hoskms—Paughkeepsie:  P.  Potter— Philadelphia :  E.  C. 
Mielke — Baltimore  :  William  &  Jos.  Neale — Washington  City :  Thompson  &  Homaiis— Jizc^ 
niond:  Robt.  J.  Smith— Nashville :  J.  P.  Ayers,  &  Co.— Mottle ;  J.  S.  Kellogg— Tuscaloosa 
Pfifiter  &  Co. 

1833. 


ENTERED  ACCORDING  TO  THE  ACT  OF  CONGRESS,  1833, 

BY  DAVID  MEREDITH  REESE, 

IN  THE  OFFICE  OF  THE  CLERK  OF  THE  SOUTHERN  DISTRICT  OF  NEW  YORK. 


PREFACE. 


The  folloxdng  plain  and  practical  observations  on  Cholera, 
have  been  prepared  at  the  suggestion  of  many  distinguished 
members  of  the  profession,  and  others,  who  have  communicated 
to  the  author  their  impression  that  a  brief  and  perspicuous  work, 
adapted  to  popular  instruction,  on  the  important  subject  of  the 
late  epidemic,  might  be  extensively  useful  to  our  citizens.  The 
great  ignorance  of  the  unprofessional  portion  of  our  population 
on  the  subject,  was  obviously  the  prolific  source  of  much  impru- 
dence, and  threw  the  timid  into  a  consternation  and  terror  which 
prevented  the  adoption  of  any  uniform  and  rational  mode  of  pre- 
vention ;  while,  at  the  same  time,  the  vague  as  well  as  contra- 
dictory opinions  which  have  found  their  way  into  the  public 
press,  upon  the  subject  of  the  causes,  prevention,  and  cure  of 
Cholera,  have  been  very  far  from  inspiring  confidence  in  the 
members  of  our  profession ;  and  in  such  perilous  times,  this  con- 
fidence w^as  more  than  ever  necessary  and  important. 

With  the  design,  then,  of  enlightening  the  uninformed  upon  a 
subject  of  vast  interest  to  the  public  health,  and  with  the  view  of 
attempting  the  removal  of  those  terrors  which  overspread  the 


4  PREFACE. 

American  community  on  the  first  visitation  of  this  epidemic,  dur- 
ing the  last  year,  the  following  pages  have  been  prepared,  amid 
the  busy  avocations  of  professional  duty,  which  afford  the  author 
but  brief  intervals  of  time,  and  these  subject  to  much  interruption. 
Under  such  circumstances,  many  imperfections  of  style  and  ar- 
rangement may  be  apparent.  But  for  the  facts  he  has  recorded, 
for  the  opinions  he  has  expressed,  and  for  the  practice  he  recom- 
mends, he  confidently  relies  upon  the  future  for  their  ample 
confirmation,  especially  if,  as  is  feared  by  many  we  should  be 
soon  visited  by  a  recurrence  of  the  epidemic,  which  may  Heaven 
avert. 

The  scenes  of  July,  August,  and  September,  1832,  are  ever 
present  in  his  memory,  and  for  the  fervency  and  zeal  with  which 
he  urges  his  protest  against  the  preventive  and  remedial  powers 
of  Ardent  Spirits,  he  will  need  no  apology  with  those  who  wit- 
nessed the  rage  of  the  pestilence  in  New  York,  and  passed 
through  the  arduous  labours  and  perils  of  that  evil  day,  when  dis- 
ease and  death,  in  their  most  appalling  forms,  stalked  through  our 
city.  With  others  who,  impelled  by  the  desire  of  avoiding  the 
unprofitable  labours  w^hich  such  calamities  impose  on  our  pro- 
fession, deserted  their  posts  in  time  of  danger,  or  sought  refuge 
from  their  personal  fears  by  inglorious  flight,  he  may  re- 
quire some  apology  for  the  confidence  with  which  he  expresses 
his  censures  upon  practice  of  which  they  have  heard  much  but 
seen  nothing.  But  to  his  professional  brethren,  in  this  city  and 
elsewhere,  who  continued  to  perform  their  duty  in  "  wrestling 
with  death,"  most  frequently  without  pecuniary  reward,  and  al- 


PREFACE.  5 

ways  without  any  adequate  renmneration  for  labours  so  arduous 
and  perilous ;  to  them  he  appeals  in  confirmation  of  the  wide- 
spread and  fatal  mischiefs  which  the  continued  sale  and  use  of 
spirituous  liquors  occasioned  in  the  causation  of  Cholera,  both  in 
its  attacks  and  in  its  fatal  results.  And  whatever  may  have  been 
their  views  at  the  commencement  of  the  epidemic,  there  are  many 
whose  eyes  were  opened  by  the  startling  and  horrible  facts  which 
were  daily  presented  to  their  observation,  and  who  had  the  mag- 
nanimity to  unite  in  the  testimony  against  it,  which  some  of  us 
felt  it  a  sacred  duty  to  bear,  ah  origine,  amidst  a  torrent  of  preju- 
dice, malevolence,  and  reproach. 

It  is,  however,  fortunate  for  the  public,  that  the  connexion  be- 
tween Rum  and  Cholera  became  so  apparent  in  the  course  of  the 
disease  in  this  city  and  elsewhere,  that  it  needs  not  the  testimony 
of  the  faculty  in  any  place  to  declare  and  maintain  it.  And  the 
impulse  given  to  the  temperance  reformation  by  the  fearful  cata- 
logue of  facts  developed  during  the  existence  of  Cholera  among 
us,  is  not  among  the  least  of  the  ways  in  which  the  God  of  Pro- 
vidence has  brought  "  good  out  of  evil."  And  although  we  have 
been  called  to  mourn  the  loss  of  a  number  of  estimable  and  vir- 
tuous citizens,  w^ho  fell  by  the  destroyer  in  many  places,  yet  if 
our  community  will  only  profit  by  the  lesson  which  has  been  so 
painfully  taught  us  the  past  year  ;  and  if  our  civil  and  municipal 
authorities  will  now  take  warning,  and  interpose  their  jurisdic- 
tion for  the  protection  of  health  and  life,  by  aiding  the  great  work 
of  banishing  the  traffic  and  use  of  ardent  spirits  from  our  coun- 
try ;  such  a  consummation  would  be  cheaply  purchased,  if  the 


6  PREFACE. 

sacrifice  of  tenfold  more  excellent  citizens  than  have  fallen  had 
been  necessary  to  achieve  it.  And  there  are  many  among  the 
benevolent  and  philanthropic  of  the  land  who  have  such  views  of 
the  importance  of  this  resuh,  that,  to  accomplish  it,  they  would 
cheerfully  have  consented  to  be  themselves  the  victims. 

That  the  following  pages  may  aid  in  producing  this  result, 
and  that,  in  the  event  of  a  re-visitation  of  the  epidemic  to  any 
portion  of  our  land,  they  may  diminish  the  mischiefs  and  fatality 
of  the  Cholera,  is  the  humble  hope  and  ardent  wish  of 

THE  AUTHOR. 

May  20th,  1833. 


TREATISE 


ON 

EPIDEMIC  CHOLERA. 


I.   The  Nature  of  the  Disease. 

The  science  of  medicine  is  not  more  defective  in 
any  other  peculiarity  than  in  its  nomenclature.  Mor- 
bid agents,  diseases,  and  even  remedies,  are  often 
distinguished  by  names  which  are  not  only  ambigu- 
ous and  unintelligible,  but  which  convey  erroneous 
ideas  of  the  nature  of  the  subjects  to  which  these 
names  are  applied. 

This  is  eminently  true  of  the  disease  under  consi- 
deration ;  for  the  term  Cholera,"  which  is  generi- 
cally  applied  to  it.  is  calculated  to  give  a  false  view 
of  the  whole  subject.  The  true  meaning  of  this 
word,  Cholera,  is  "  an  undue  flow  of  bile,"  being  de- 
rived, according  to  Celsus,  from  zcxt^  and  literally 
bile-flux ;  while  one  of  the  most  distinctive  peculiari- 
ties of  the  disease  to  which  this  name  is  applied,  is  a 
suppression  both  of  the  secretion  and  excretion  of  bile. 
This  term  is,  therefore,  a  misnomer ;  and  yet  it  has 
been  so  long  associated  with  the  disease  in  question, 
that  it  would  be,  perhaps,  impossible  to  effect  its 
abandonment ;  especially  while  the  most  of  the  other 
specific  epithets  adopted  or  proposed  in  lieu  of  it  are 


8 


TREATISE  ON  EPIDEMIC  CHOLERA. 


open  to  equally  valid  objections.  It  may  be  neces- 
sary to  retain  the  name,  therefore,  notwithstanding 
its  philological  inaccuracy  and  inappropriateness. 

But,  although  it  is  essentially  different  in  its  na- 
ture from  the  Cholera  Morbus  of  our  country,  and  not 
an  aggravated  form,  as  has  been  erroneously  suppo- 
sed, yet  it  is  not  a  new  disease  to  the  world,  or  to  the 
country  either ;  and  this  fact,  where  it  is  understood 
and  believed,  removes  much  of  its  frightful  character. 
The  consternation  ar^ong  the  community,  and  the 
blunders  of  the  faculty,  as  well  as  the  ill  success  that 
has  proverbially  attended  its  treatment,  may  be 
chiefly  traced  to  the  mistake  of  supposing  it  to  be  a 
new  disease.  This  leads  patients  to  distrust  their 
medical  advisers,  and  resort  to  nostrums ;  and,  on 
the  other  hand,  leads  physicians  to  prescribe  for  the 
Cholera  some  one  of  the  varied  and  opposite  reme- 
dies with  which  the  book  market  has  been  indis- 
criminately deluged.  If  physicians  would  treat  this 
disease  according  to  the  symptoms,  and  seem  not  to 
know  what  to  call  it,  instead  of  prescribing  for  the 
name  of  this  strange  destroyer,  we  should  soon  find, 
among  the  enlightened  and  scientific,  a  uniform  and 
successful  system  of  practice. 

Instead,  however,  of  prescribing  for  the  symptoms, 
as  they  present  themselves  in  every  individual  case, 
and  proportioning  the  remedies  to  the  violence  of  the 
attack,  it  is  to  a  lamentable  extent  the  fact,  that  some 
physicians  were  filled  with  perturbation  at  witness- 
ing the  first  symptoms  of  the  epidemic.  Dreading  the 
very  name  of  Cholera,  to  which  they  had  been  taught 
to  attach  the  idea  of  sudden  and  certain  fatality, 


TREATISE  ON  EPIDEMIC  CHOLERA. 


9 


they  prescribed  as  though  they  were  doubtful  whe- 
ther their  remedy  would  kill  or  cure  the  patient,  and 
used  some  one  of  the  varied  and  contradictory  reme- 
dies which  have  been  successively  eulogized  by  fo- 
reign practitioners.  Hence,  as  calomel,  ophun,  brandy^ 
bleedings  cold  and  heat,  have  each  found  advocates  in 
other  countries,  by  bold  experimentalists,  there  were 
those  who,  unwilling  to  trust  to  either  singly,  in  con- 
tending with  this  new  enemy,  would  rapidly,  and 
even  simultaneously,  adopt  the  whole.  If  they  be- 
gan by  bleeding  with  one  hand,  they  would  give 
brandy  with  the  other.  If  they  gave  calomel  for  its 
purgative  quality,  they  would  give  opium  for  fear  of 
accidents.  If  they  used  cold,  whether  internally  or 
externally,  they  would  counteract  it  by  heat.  And 
thus,  if  patients  did  not  get  well,  they  knew  not 
whether  they  died  of  the  disease  or  the  remedies,  for 
either  would  singly  have  proved  fatal;  and  if  they 
recovered,  in  spite  of  the  treatment,  then  each  and  all  of 
these  contradictory  remedies  were  lauded  to  the  skies. 
In  the  commencement  of  the  epidemic,  in  very  many 
instances,  it  was  found  that  the  patient  had  been 
subjected  to  all  these  agents  before  the  case  had  ter- 
minated ;  and  there  is  reason  to  believe,  that  many 
were  subjected  to  the  most  of  them,  before  it  was  dis- 
covered that  they  had  not  suffered  from  the  disease, 
but  only  from  the  dread  of  it ;  and  such  cases  were 
significantly  called  Cholera-phobia. 

Beside  this  palpable  objection  to  the  name  of  the 
disease,  the  ambiguity  of  the  whole  subject  is  in- 
creased by  the  loose  definitions  which  have  been  gi- 
ven of  it  by  transatlantic  as  well  as  American  writers. 
2 


10 


TREATISE  ON  EPIDEMIC  CHOLERA. 


Scarcely  any  two  of  them  can  be  found  who  agree 
in  their  definition,  or  in  their  account  of  the  promi- 
nent and  diagnostic  symptoms  ;  while  the  attempt  to 
divide  the  disease  into  Cholera  and  Cholerine,  and 
also  into  different  stages,  as  they  would  the  pa- 
roxysms of  an  intermittent,  is  for  the  most  part  vision- 
ary and  absurd.  Indeed,  it  is  difficult  to  give  an  ab- 
stract definition,  with  any  tolerable  accuracy,  of  a 
disease  so  variable  in  its  features,  so  rapid  in  its 
progress,  and  so  sudden  as  it  often  is  in  its  onset 
and  in  its  result.  Hence,  the  attempts  to  generalize 
the  subject,  by  defining  its  nature  in  a  few  words, 
have  been  unsuccessful ;  and  they  have  been  so,  be- 
cause there  are  so  many  striking  and  characteristic 
symptoms,  that  they  cannot  readily  be  compressed 
into  the  brevity  desirable  in  a  definition. 

Dr.  John  Mason  Good  defines  it  thus,  viz. :  "  The 
dejections  watery ;  ineffectual  retchings,  or  vomitings 
ol  a  whitish  fluid ;  spasms  successive  and  violent, 
often  extending  to  every  organ ;  great  despondency 
and  prostration  of  strength."'  It  is  evident,  however, 
that  this  writer  never  saw  the  disease,  or  he  would 
not  have  thus  stopped  short  of  the  most  striking  fea- 
tures of  its  severest  forms,  and  he  would  have  added 
the  following :  "  pain  at  the  pit  of  the  stomach  ; 
giddiness  ;  urgent  thirst  ;  suspension,  nearly  com- 
plete, of  the  action  of  the  heart  and  arteries,  with  its 
necessary  consequence,  failure  of  secretion  and  of  ani- 
mal heat,  as  exhibited  in  asphyxia ;  cold  surface, 
cold  tongue  and  breath,  and  suppression  of  the  uri- 
nary and  biliary  discharges."  But,  beside  all  these, 
there  are  other  symptoms  of  a  characteristic  nature. 


TREATISE  ON  EPIDEMIC  CHOLERA.  11 

in  the  most  formidable  cases,  viz.:  '-the  wliispering 
voice;  tlie  blueness  and  wrinkled  integuments  of 
the  extremities ;  the  doughy  feel  of  the  abdomen  and 
muscular  structure;  the  livid  siirunk  countenance, 
with  the  glazed  and  sunken  eye,  so  expressive  of 
anxiety  and  suffering,  and  which  add,  in  so  remark- 
able a  manner,  to  the  apparent  age  of  the  patient; 
together  with  the  extraordinary  sweat  which  lite- 
rally streams  from  every  pore  of  the  body/'  These 
are  circumstances  which,  if  once  witnessed,  impress 
the  memory  too  forcibly  to  be  forgotten,  and  cannot 
fail  to  be  immediately  recognized  when  exhibited 
in  succeeding  cases ;  and  the  same  may  be  said  of 
the  discharges  from  the  stomach  and  intestines,  which 
have  received  the  appropriate  appellation  of  congee^ 
or  rice-water,  and  may  properly  be  considered  as 
peculiar  to  this  disease. 

Such  are  the  numerous  and  appalling  symptoms 
w^hich  attend  this  formidable  disease;  and  in  its  in- 
tensest  form,  it  is  susprising  with  what  accuracy  they 
may  all  be  observed,  not  one  of  them  being  absent. 
And  yet  in  the  worst  cases,  with  all  this  concatena- 
tion of  alarming  features,  while  the  circulation  is  so 
nearly  at  a  stand  that  no  pulsation  can  be  felt  in 
any  vessel  of  the  body,  the  sensorial  powers  remain 
unaffected,  nearly,  if  not  entirely,  to  the  last.  The 
patient  is  sensible,  and  answers  with  distinctness 
any  question  put  to  him,  though  it  may  be  in  mono- 
syllables only ;  while  an  indescribable  calmness  and 
composure  of  mind  is  strikingly  evident.  He  also 
occasionally  retains  his  muscular  strength;  so  that  he 
will  sit  up  in  the  bed,  or  even  walk,  if  permitted,  to 


12 


TREATISE  ON  EPIDEMIC  CHOLERA. 


do  SO,  while  the  respiration  goes  on  with  ease  and 
regularity  till  within  a  few  minutes  of  death. 
.  This  catalogue  of  symptoms  is,  however,  rather 
applicable  to  a  stage  of  the  disease,  than  to  its  entire 
course ;  yet  this  stage,  as  it  is  called,  is  not  only  the 
most  striking  and  characteristic,  but  often,  especially 
in  the  beginning  of  the  epidemic,  may  be  the  only 
one  which  exhibits  itself  to  our  notice.  So  sudden 
is  the  invasion,  in  some  instances,  that  the  patients 
compare  it  to  a  blow  of  a  club ;  and  according  to  Dr. 
Smith  this  comparison  was  frequently  made  in  Paris 
by  the  patients,  who  described  it  as  a  ^^coup  de  hatony 
It  is  true,  that  in  a  large  majority  of  cases,  the  train  of 
formidable  symptoms  we  have  described,  however 
suddenly  they  may  have  been  successively  developed, 
are  preceded  by  what  are  called  premonitory  symp- 
toms." These  are,  "  a  sense  of  coldness  on  the  surface 
of  the  body,  accompanied  with  languor,  but  not 
amounting  to  a  chill;  impaired  appetite  and  digestion; 
a  diarrhoea  of  some  hours  or  days  in  duration ;  a  slight 
headache,  with  a  noise  or  ringing  in  the  ears ;  and 
not  unfrequently  some  pain  at  the  pit  of  the  sto- 
mach or  in  the  abdomen,  with  a  sense  of  tightness 
in  breathing,  which  gives  an  inclination  to  sigh. 
Vomiting  occurs  simultaneously  in  some  instances, 
especially  if  any  ingesta  has  been  recently  taken 
into  the  stomach,  or  if  that  organ  has  been  previously 
impaired  by  dyspepsia  or  otherwise.  A  slight  cramp 
is  often  felt  in  the  soles  of  the  feet,  the  calves  of  the 
legs,  and  sometimes  in  the  other  extremities."  And 
when  these  several  signs  have  been  present  a  few 
hours,  if  relief  be  not  obtained,  the  second  stage,  or 


TREATISE  ON  EPIDEMIC  CHOLERA. 


13 


paroxysm,  to  which  the  term  Cholera  Asphyxia  is 
generally  applied,  will  soon  supervene.  The  symp- 
toms of  this  appalling  condition  have  already  been 
named  in  our  attempt  at  its  definition  in  the  prece- 
ding pages.  Sometimes  they  present  themselves  suc- 
cessively, and  are  several  hours  before  the  whole  are 
developed;  but  in  a  majority  of  instances  this  for- 
midable array  of  terrifying  symptoms  appear  almost 
simultaneously.  Such  is  the  extraordinary  change 
in  the  countenance  of  the  patient  in  some  cases  after 
lying  in  this  state  but  a  single  hour,  so  astonishing 
is  the  alteration  of  the  features  and  the  colour  of  the 
skin,  that  he  would  hardly  be  known  by  his  inti- 
mate friends ;  and  the  entire  change  in  his  voice, 
which  is  almost  universal,  defies  recognition.  But 
still  the  patient  suffers  little  or  no  pain,  and  ordina- 
rily preserves  a  calm  and  collected  state  of  the  mind, 
betraying  no  apprehension  or  alarm,  amid  the  utter 
wreck  of  the  powers  of  life,  so  visible  to  every  be- 
holder. And  now  if  prompt  and  energetic  reme- 
dies be  not  diligently  employed,  the  case  will  ter- 
minate fatally  in  from  four  to  twenty  hours. 

In  the  event  of  the  successful  efforts  of  art,  in  car- 
rying the  patient  through  this  state  of  asphyxia, 
collapse  or  blue  stage  as  it  has  been  called,  a  new 
train  of  symptoms  exhibit  themselves,  which  has 
been  designated  by  the  name  of  the  third  stage  of  Cho- 
lera, though  in  fact  it  is  the  reaction  necessary  to  con- 
valescence. Still,  however,  it  calls  for  judicious  and 
diligent  management,  that  it  may  be  aided  v/hen  too 
languid,  or  moderated  if  too  violent,  and  the  latter  is 
most  frequently  the  case  :  for  the  vascular  reaction  is 


14 


TREATISE  ON  EPIDEMIC  CHOLERA. 


ordinarily  proportionate  to  the  intensity  of  tiie  pre- 
ceding train  of  phenomena,  as  might  be  anticipated 
from  analogy.  Hence,  for  the  protection  of  the  vital 
organs,  very  active  depletion  is  often  required.  This 
reaction,  if  it  be  protracted,  as  is  frequently  the 
case,  has  received  the  name  of  "consecutive  fever,"  and 
invariably  bears  the  marks  of  congestive  or  typhus 
fever  so  plainly,  that  if  it  were  not  unfortunately 
regarded  as  a  sequel  of  Cholera,  and  therefore  deem- 
ed to  be  of  specific  character,  would  uniformly  be 
recognised  and  treated  accordingly.  It  is  painful  to 
recollect  how  many  instances  occurred  in  this  city, 
in  which  persons  were  safely  brought  through  the 
paroxysm  of  asphyxia,  and  yet  afterwards  fell  vic- 
tims to  consecutive  fever,  and  this  too  after  they  were 
reported  as  convalescent  and  even  cured;  and  after 
they  had  been  trumpeted  as  the  trophies  of  some  one 
or  other  of  the  numerous  specifics,  each  of  which  had 
its  advocates,  however  mischievous  or  even  inert. 

I  have  thus  given  the  views  of  the  different  wri- 
ters who  concur  in  tracing  three  distinct  stages  in  the 
Cholera,  viz.:  1.  The  stage  of  irritation;  2.  The  stage 
of  collapse  ;  and,  3.  The  stage  of  reaction. 

In  reference  to  this  part  of  the  subject,  I  remark, 
that  the  first,  or  irritative  stage,  as  it  is  called,  is  not 
entitled  to  this  conventional  appellative,  Cholera : 
1st.  Because  it  has  no  certain  diagnostics  by  which 
it  may  be  distinguished  with  certainty  from  intesti- 
nal or  vascular  irritation,  arising  from  other  causes; 
2d.  Because  many  cases  of  Cholera,  in  its  worst 
form,  occur  in  every  place  in  which  this  stage,  in  its 
sensible  signs,  has  been  wholly  absent ;  and,  3dly, 


TREATISE  ON  EPIDEMIC  CHOLERA. 


15 


because  I  believe  the  "premonitory  symptoms"'  con- 
stituting this  stage  are  in  their  nature  prophylactic, 
or  preventive.  The  ^'^  diarrhaa^^  for  which  there  are 
ten  thousand  empirical  specifics,  which  stupidity,  and 
what  is  worse,  cupidity,  has  invented  in  the  form  of 
stimulants,  astringents,  and  narcotics,  is,  in  its  true 
character,  none  else  than  the  result  of  the  efforts  of 
nature  for  her  own  protection.  It  is  an  effort  of  the 
vis  medicatrix  naturcB^  to  overcome  the  morbid  action, 
and  restore  the  balance  of  the  circulation ;  and  which, 
instead  of  being  treated  as  the  first  stage  of  Cholera, 
and  suppressed  at  its  commencement,  as  is  too  often 
mischievously  done,  should  invariably  indicate  the 
appropriate  treatment  by  mild  and  gentle  purgatives. 
And  so  of  the  vomiting,  which  often  takes  place 
simultaneously  with  this  diarrhoea,  and  hence  very 
many  judicious  physicians  have  employed  salt  and 
water,  or  some  other  safe  emetico-cathartic,  in  these 
early  symptoms,  and  with  signal  success. 

It  is  in  the  collapse  or  second  stage  only,  that  the 
disease,  to  which  the  conventional  appellative  Cho- 
lera can  be  properly  applied,  is  to  be  certainly  recog- 
nised ;  or  with  which  its  characteristic  symptoms 
can  be  distinguished.  The  term  spasmodic"  can- 
not be  justly  used,  in  contradistinction  to  the  ordi- 
nary Cholera  Morbus  of  our  climate,  until  arrested 
secretions  and  an  obstructed  circulation  develope  the 
collapsed  state  of  the  surface,  and  asphyxia,  partial  or 
complete,  is  present,  for  the  obvious  reason,  that  the 
spasms  are  more  frequent  and  severe  in  common 
Cholera  Morbus,  than  they  often  are  in  the  worst 
cases  of  the  epidemic ;  and  indeed  many  fatal  instan- 


16 


TREATISE  ON  EPIDEMIC  CHOLERA. 


ces  have  occurred  in  which  there  was  little  or  no  ex- 
ternal spasm  during  their  whole  course.  And  the 
spasmodic  contraction  of  the  muscles  of  the  extremi- 
ties, which  are  described  as  characteristic  of  the  first 
or  premonitory  stage,  are  not  greater  than  frequently 
exist  in  other  internal  diseases.  When  the  incipient 
collapse  or  second  stage,  with  approaching  asphyxia, 
exhibit  their  appalling  features,  it  is  then  that  the 
peculiar  spasms,  characteristic  of  epidemic  Cholera, 
become  so  severe  and  terrifying,  if  they  appear  at  all 
in  the  case;  and  hence  some  writers  have  defined 
this  incipient  collapse  as  a  distinct  stage,  which  they 
call  the  spasmodic  stage.  These  spasms  are,  how- 
ever, bat  a  link  in  the  chain  of  symptoms  of  the  dis- 
ease, and  properly  belong  to  the  stage  of  collapse. 

The  third  stage  as  it  has  been  called,  or  that  of  re- 
action, cannot  properly  be  dignified  by  the  title  of  a 
distinct  stage  of  Cholera,  because  it  has  no  charac- 
teristic or  diagnostic  feature,  by  which  it  can  be  dis- 
tinguished from  other  instances  of  morbid  reaction ; 
and  the  local  affections  attendant  upon  it,  are  alto- 
gether contingent  upon  the  previous  condition  of  in- 
dividual organs,  and  vary  indefinitely.  There  is, 
therefore,  much  greater  propriety  in  the  opinion  of 
Dr.  Payne  of  this  city,  in  his  excellent  letters  to  Dr. 
Warren  of  Boston,  in  which  he  regards  Cholera  as  a 
fever,  of  which  the  collajyse  is  the  first  stage,  and  re- 
action the  second.  Still,  however,  the  division  of  this 
formidable  malady  into  stages  is  one  purely  arbi- 
trary, and  for  the  most  part  serves  no  valuable  prac- 
tical purpose. 

The  same  may  be  said  of  the  "  consecutive  fever," 


TREATISE  ON  EPIDEMIC  CHOLERA. 


17 


of  which  so  much  has  been  heard,  as  one  of  the  se- 
quela of  Cholera.  The  Instances  of  recovery  from 
the  blue  stage,  or  collapse,  are  often  reported  a  few 
days  after  to  have  died  of  consecutive  fever,  by  which 
a  Typhus  or  Congestive  fever  is  meant;  and  this  is 
ordinarily  the  effect  of  the  stimulating,  or  brandy 
practice;  for  if  the  patient  live  through  the  period 
of  collapse,  by  reason  of  a  constitution  sufficiently  vi- 
gorous to  sustain  the  combined  influence  of  the  three 
poisons,  brandy,  opium,  and  Cholera,  it  is  no  mar- 
vel that  local  congestions  should  exist  which  prove 
fatal  during  this  consecutive  fever,"  which  is  conse- 
cutive, not  upon  Cholera,  but  in  most  instances  con- 
secutive upon  the  treatment,  or  the  indiscreet  ma- 
nagement of  convalescence.  Those  physicians  who 
have  treated  the  disease  by  depletion  throughout,  it 
is  every  where  known,  have  had  little  trouble  from 
any  consecutive  mischiefs  ;  and  convalescence  has 
been  speedy,  as  well  as  permanent. 

In  conclusion,  therefore,  I  also  will  show  my  opi- 
nion. I  conceive  the  essence  of  Cholera  to  consist  of 
a  retirement  of  the  circulating  mass  of  the  blood  from 
the  external  surface  of  the  body,  and  its  consequent 
accumulation  in  the  larger  and  internal  vessels.  This 
is  the  first  symptom  in  all  cases,  whether  with  or 
without  observation,  and  indeed  is  the  only  diagnos- 
tic which  is  uniform  and  infallible  in  the  early  pe- 
riod of  the  disease.  Indeed,  a  coldness  of  the  skin  is 
often  complained  of  either  before  or  at  the  com- 
mencement of  the  diarrhoea,  regarded  as  the  first 
stage  of  the  disease,  and  arises  from  the  absence  of 
the  blood  from  the  capillary  vessels.  This  loss  of 
3 


18 


TREATISE  ON  EPIDEMIC  CHOLERA. 


balance  between  the  external  and  Internal  circula- 
tion soon  results  in  an  inverted  excitement,  during 
which  the  insensible  perspiration  from  the  skin 
ceases,  and  in  bad  cases  the  exhalations  from  the 
lungs  are  partially  or  altogether  suppressed;  and 
hence  the  voice  is  so  strangely  altered,  even  before 
asphyxia  has  supervened.  In  many  instances  nature 
is  successful  in  expelling  the  morbid  impression  by 
the  diarrhoea,  especially  if  vomiting  be  superinduced 
early  in  its  course,  either  spontaneously,  or  by  the 
salt  and  water  or  mustard  emetic,  as  was  frequently 
and  judiciously  exhibited. 

The  prostration  of  the  nervous  system,  by  the  epi- 
demic influence,  is  not  only  found  to  accompany  the 
premonitory  diarrhoea,  but  is  sensibly  felt  by  those 
who,  by  judicious  means  of  prevention,  avoid  the  ex- 
citing causes,  and  entirely  escape  the  disease.  A 
sense  of  exhaustion,  however,  if  it  be  accompanied 
by  a  coldness  of  the  skin,  and  intestinal  evacuations 
of  a  watery  character  which  are  large  and  frequent, 
will,  unless  speedily  relieved,  develope  the  alarming 
characteristics  of  Cholera. 

Thus,  it  will  be  perceived,  that  I  regard  the  gene- 
ral and  almost  universal  morbid  sensations,  com- 
pjained  of  during  the  prevalence  of  Cholera,  as  only 
giving  evidence  of  liability  to  an  attack,  by  the  ope- 
ration of  the  remote  cause  having  excited  a  predis- 
position, or  epidemic  constitution,  as  it  is  sometimes 
called.  And  more  or  less  of  the  signs  of  this  predis- 
position were  found  to  exist  in  the  whole  community 
wherever  the  epidemic  has  prevailed.  It  was  known 
by  a  disturbance  of  the  digestive  organs,  a  sense  of 


TREATISE  ON  EPIDEMIC  CHOLERA. 


19 


heat,  fulness,  and  uneasiness  or  pain  in  the  abdo- 
men, a  furred  tongue,  a  sense  of  general  debility 
with  occasional  cramps  of  the  muscles,  especially  at 
night.  And  thousands  in  New-York,  and  elsewhere, 
felt  these  evidences  of  predisposition,  and  yet  altoge- 
ther protected  themselves  from  an  attack  by  prudence 
and  discretion  in  their  habits  of  living,  and  were 
not  even  afflicted  with  a  single  premonitory  symp- 
tom." 

In  like  manner,  the  diarrhoea  and  other  premoni- 
tory symptoms,  as  they  are  called,  are  all  to  be  un- 
derstood as  only  giving  evidence  that  some  one  or 
more  of  the  exciting  causes  has  been  applied,  and 
that,  under  the  epidemic  constitution  or  predisposition, 
the  disease  itself  is  about  to  be  developed,  unless  the 
indications  of  nature  be  followed,  and  the  morbid 
agency  controlled.  Still,  however,  the  patient  cannot 
be  said  to  have  Cholera,  nor  will  he  yet  suffer  from 
an  attack,  if  judicious  means  be  used.  Hence  it  has 
been  truly  affirmed,  that  in  this  stage  the  epidemic 
need  never  be  fatal,  and  accordingly  preventive  treat- 
ment is  urged  upon  all  who  suffer  from  premonitory 
symptoms  as  indispensable.  I  insist,  however,  that 
"the  thousands  who  have  been  cured  of  these  symp- 
toms, have  not  suffered  an  attack  of  Cholera. 

1  apply  the  term,  therefore,  only  to  that  train  of 
phenomena  which  present  themselves  subsequently, 
if  the  premonitory  diarrhoea  be  present,  which  is  by 
no  means  universal.  For  in  many  cases,  particularly 
during  the  rise  and  at  the  climax  of  the  epidemic, 
the  attack  has  been  sudden,  and  even  instantaneous, 
and  the  patient  is  "  seized  with  the  Cholera,"  or  in 


20 


TREATISE  ON  EPIDEMIC  CHOLERA. 


the  language  of  many  of  the  patients  in  Paris,  who 
represent  themselves  as  struck  with  a  blow ; — 
"  frappe  comme  d'un  coup  de  baton."  In  India,  by 
the  testimony  of  Dr.  Johnson,  there  were  no  premo- 
nitory symptoms. 

Most  generally  however,  it  must  be  confessed,  that, 
in  this  country,  the  onset  of  the  disease  has  been 
preceded  by  diarrhoea  of  some  hours,  and  frequently 
of  some  days  duration.  In  all  cases  in  which  this 
premonitory  diarrhoea  ceases  spontaneously,  is 
checked  by  art,  or  is  inadequate  to  the  expulsion  of 
the  disease,  which  is  often  the  fact  in  bad  cases, 
an  attack  of  Cholera,  properly  so  called,  will  super- 
vene. The  patient  will  now  have  pain  in  the  bow- 
els and  in  the  chest,  vomiting,  with  coldness  of  the 
skin,  tongue,  and  breath,  increasing  prostration  of 
strength,  spasms  in  the  limbs,  and  often  in  the  abdo- 
men and  thorax,  and  the  pulse  will  be  found  to  be 
laboured,  and  indicate  that  state  of  the  circulation 
known  among  physicians  as  one  of  suffocated  ex- 
citement. If  these  symptoms  be  not  promptly  re- 
lieved by  art,  the  patient  will  very  soon  fall  into  a 
state  of  collapse,  as  it  is  vaguely  called,  evinced  by 
asphyxia,  or  a  total  loss  of  pulse  at  the  wrist,  im- 
peded or  obstructed  breathing,  an  increase  in  the 
character  and  extent  of  the  spasms,  a  profuse,  morbid 
perspiration,  over  the  whole  body,  with  a  thirst  that 
is  intolerable,  a  total  suppression  of  the  urinary  and 
other  secretions,  and  an  alarming  increase  in  the  vo- 
miting or  purging,  or  both. 

These  are  the  true  characteristic  symptoms  of 
Cholera,  and  without  the  most  of  these  the  patient 


TREATISE  ON  EPIDEMIC  CHOLERA. 


21 


cannot  be  said  to  have  the  disease,  whatever  signs 
of  predisposition,  or  premonitory  symptoms,  he  may 
have  presented.  When  most,  or  all,  of  these  alarming 
features  have  subsisted  over  three  or  four  hours,  the 
case  will  often  defeat  the  best  directed  efforts.  If, 
however,  they  have  just  appeared,  or  have  existed 
but  for  an  hour  or  two,  they  are  not  so  formidable  as 
has  often  been  represented.  Into  this  state,  justly 
denominated  the  incipient  collapse^  most  of  the  cases 
had  fallen  in  the  early  progress  of  the  epidemic,  be- 
fore physicians  were  called,  and  the  treatment  of 
such  symptoms  was  therefore  the  first  lesson  we  had 
to  learn. 

The  reaction  and  consecutive  fever,  of  which  so 
much  has  been  said,  I  have  already  affirmed  to  have 
no  peculiarity  by  which  they  can  be  distinguished 
from  these  morbid  phenomena  when  they  are  the 
sequela  of  other  congestive  diseases ;  and  their  ob- 
stinacy and  danger  is  ordinarily  the  result  of  previ- 
ous neglect  or  mismanagement.  Experience  has 
amply  demonstrated  that  even  after  convalescence 
commences,  by  a  single  act  of  Imprudence  or  excess  in 
eating,  and  especially  if  any  irritating  medicine  be 
given  as  a  purgative  or  otherwise,  the  most  disas- 
trous results  will  follow.  Several  instances  occurred 
within  my  knowledge,  in  cases  which  had  decidedly 
convalesced,  that  by  taking  a  single  glass  of  wine,  or 
brandy  to  strengthen  them :  or  a  simple  dose  of  rhu- 
barb or  castor  oil,  injudiciously  prescribed  by  some 
officious  neighbour,  a  consecutive  fever  was  ushered 
in  which  resisted  every  remedy,  and  terminated  fa- 
tally in  a  few  days.    In  some  few  cases,  the  same 


22 


TREATISE  ON  EPIDEMIC  CHOLERA. 


result  was  observed  to  follow  by  indulging  that  mor- 
bid hunger  which  attends  convalescence,  by  a  single 
meal.  These  and  similar  facts  show  the  importance 
of  the  greatest  possible  caution,  in  those  who  have 
passed  safely  through  the  severe  form  of  the  disease, 
and  that  during  their  recovery  their  food  should  be  of 
the  simplest  kind,  and  but  sparingly  taken ;  and 
above  all,  that  they  should  take  no  kind  of  stimula- 
ting drink  or  irritating  medicine. 

Relapses  were  seldom  if  ever  observed  to  occur; 
but  mismanagement,  soon  after  recovery,  was  follow- 
ed by  this  fever  of  which  we  have  been  speaking. 
Numerous  instances  of  a  second  attack  of  Cholera 
were  witnessed,  some  of  which  were  fatal ;  but 
such  second  attack  was  invariably  the  result  of 
gross  imprudence  or  excess,  and  generally  in  the  use 
of  ardent  spirits. 


II.  Causes  of  the  Disease. 

The  subject  of  cause  and  causation  has  long  been 
deemed  the  terra  incognita  of  medical  philosophy, 
by  reason  of  the  various  hypotheses  with  which  the 
profession  has  been  wont  to  employ  themselves  and 
amuse  the  public.  It  cannot  be  denied,  however,  that 
the  genius,  industry,  and  learning  of  almost  every 
age,  have  been  vigilant  in  investigating  the  causes  of 
epidemic  diseases,  and  the  result  of  these  labours  is 
seen  in  the  fact,  that  the  periodical  visitations  of  such 
calamities  have  been  combated  on  each  of  their  sue- 


TREATISE  ON  EPIDEMIC  CHOLERA. 


23 


cessive  returns  with  increasing  confidence  and  in- 
creasing success. 

The  history  of  these  United  States  has  been  mark- 
ed by  the  occasional  visitation  of  contagious,  infec- 
tious, epidemical,  and  endemical  diseases,  some  of 
which  have  been  aboriginal  or  indigenous  to  our  soil, 
and  may  be  regarded  as,  in  some  sense,  peculiar  to 
the  climate  ;  while  others  have  been  known  in  other 
countries  long  before  they  appeared  among  us,  hav- 
ing either  been  transmitted  by  contagion,  or  origi- 
nated here  from  the  same  causes  which  produced 
them  elsewhere. 

It  must  be  conceded,  however,  that,  familiar  as  we 
have  become  with  the  occurrence,  prevalence,  and 
fatality  of  various  epidemics,  the  appearance  of  the 
Cholera,  among  the  events  of  the  past  year,  has  pro- 
duced an  effect  upon  the  public  mind  far  more  abi- 
ding and  universal  than  that  of  any  former  similar 
calamity  ever  known  among  us.  Our  citizens  had 
heard  and  read  much  of  this  Asiatic  scourge,  and  all 
we  knew  of  it  had  impressed  us  with  a  sense  of  its 
mysterious  character,  its  rapid  and  erratic  course,  its 
unmanageable  and  incurable  nature,  and  its  certain 
and  dreadful  fatality.  Its  fearful  devastations  in 
India  and  elsewhere  had  filled  the  mind  with  horror 
at  the  bare  recital  of  its  ravages,  and  the  rumor  of 
its  appearance  on  the  shores  of  the  St.  Lawrence 
threw  our  population  into  consternation,  which  in- 
creased to  an  alarming. degree  as  the  evidences  of  its 
existence,  and  the  probability  of  its  extension,  be- 
came known  in  the  community.  This  consternation 
and  dread  was  felt  to  a  greater  or  less  extent  by  al- 


24, 


TREATISE  ON  EPIDEMIC  CHOLERA. 


most  every  individual  in  the  community,  and  we 
were  called  to  witness  the  most  appalling  effects  from 
this  mental  horror,  which,  in  some  instances,  became 
so  intense  as  to  dethrone  reason  itself,  and  impel  to 
suicide. 

The  history  of  this  formidable  disease,  in  the  va- 
rious countries  which  have  been  successively  the 
theatres  of  its  ravages,  has  uniformly  furnished  the 
same  evidences  of  its  origin,  spread,  and  fatality ;  and 
therefore  when  we  become  acquainted  with  its  course 
in  any  one  city  or  country,  we  are  prepared  to  un- 
derstand its  nature  and  causes  as  fully  as  we  could 
by  the  most  detailed  account  of  successive  visitations 
in  different  and  distant  places.  For  this  reason  I  shall 
not  dwell  in  detail  upon  its  history  in  the  various 
countries  where  its  track  has  been  one  of  devasta- 
tion and  death;  nor  shall  I  trace  its  progress  through 
our  own  country,  many  portions  of  which  have 
been  visited  during  the  last  year ;  but  must  refer 
to  the  works  professedly  written  on  this  department 
of  the  subject.  But  I  propose  to  myself  only  a  brief 
summary  of  the  etiology  of  Cholera,  as  it  prevailed 
in  the  city  of  New  York  during  the  months  of  July, 
August,  and  September,  1832,  and  refer  to  its  history 
in  other  places,  only  by  way  of  illustration. 

Among  the  supposed  causes  of  Cholera,  the  opinion 
most  general  among  the  unprofessional,  and  one 
which  receives  the  sanction  of  many  distinguished 
physicians  in  other  countries,  and  of  a  few  such  in 
America,  is  that  it  arises  from  a  specific  contagion^ 
and  of  course  that  it  is  communicated  from  one  place 
to  another  by  persons  or  things,  as  the  small  pox 


TREATISE  ON  EPIDEMIC  CHOLERA. 


25 


and  other  contagious  fevers  are  propagated.  The 
obvious  and  irreconcilable  difficulties  in  the  way  of 
this  doctrine,  exhibited  with  uniformity  in  every 
place  where  it  has  prevailed,  have,  however,  com- 
pelled its  advocates  to  invent  a  modification  of  their 
theory,  and  hence  they  have  adopted  the  terms  ^'-con- 
tingent contagion"  as  expressive  of  the  opinion  that 
it  is  contagious  onli/  under  some  peculiar  atmospheric 
circumstances.  This  theory,  however,  only  involves 
the  subject  in  still  greater  obscurity.  For,  if  the 
disease  be  strictly  a  contagious  fever,  it  can  originate 
from  no  other  cause  than  contagion^  and  hence  the 
term  contingent^  as  applied  to  contagion,  in  this  case 
is  absurd.  Even  its  advocates  concur  in  admitting 
that  it  may  and  often  does  originate  from  other 
causes,  and  that  it  afterwards  becomes  contagious  by 
reason  of  adventitious  circumstances,  though  it  is  not 
so  without  them.  This  is  virtually  an  abandonment 
of  the  known  laws  of  contagion,  and  seems  to  be 
the  dernier  resort  of  those  who  have  not  the  magna- 
nimity to  abandon  their  favourite  theory,  though  a 
multitude  of  facts  have  demonstrated  its  fallacy. 

That  the  Cholera  arises  from  contagion,  under  ayiy 
circumstances,  is  only  believed  in  this  country  by 
those  few  physicians  who  are  professed  contagion- 
ists,  and  who  prove  their  consistency  by  applying 
their  doctrine  to  epidemic  dysentery,  typhus,  puer- 
peral, and  yellow  fever,  as  well  as  Cholera.  The 
facts,  however,  occurring  in  the  late  visitation  of  this 
latter  epidemic,  have  caused  many  of  these  to  re- 
nounce their  preconceived  opinions,  and  it  may  be 
safely  affirmed  that,  among  the  intelligent  and  en- 
4 


26 


TREATISE  ON  EPIDEMIC  CHOLERA. 


lightened,  "both  in  and  out  of  the  profession,  there 
exists  very  little  confidence  in  the  contagious  nature 
of  Cholera  at  the  present  time. 

It  is  evident  to  the  most  superficial  observer,  that 
we  must  look  elsewhere  for  the  causes  of  Cholera 
than  to  emigration  or  importation,  as  the  disease  has 
appeared  in  cities  and  countries  whose  cordon  sani- 
taire  and  quarantine  regulations  have  successfully 
protected  them  from  other  contagious  diseases  for 
centuries;  and  it  has  also  originated  in  individuals, 
and  under  circumstances  where  the  supposition  of 
contagion  is  excluded  by  absolute  impossibility. 

The  numerous  opinions  which  have  been  started 
by  Asiatic,  European,  and  American  physicians,  have 
been  so  various  and  even  opposite  in  their  character, 
that  it  would  only  perplex  the  reader  even  to  name 
them.  The  remote  predisposing,  exciting,  and  prox- 
imate causes,  have  all  been  named  by  difl'erent  wri- 
ters, and  scarcely  two  have  agreed  concerning  either, 
although  equally  dogmatical.  Hence  the  mystery 
which  has  been  thrown  around  the  whole  subject, 
the  terrors  existing  in  the  community,  and  the  sig- 
nal fatality  which  has  attended  the  disease.  Even 
among  those  who  have  become  convinced  that  it  is 
strictly  an  epidemic  disease,  many  have  imagined  that 
it  defies  all  analogy,  and  therefore  represent  it  as  a 
"  nova  pestis^ 

It  has  been  long  known  that  some  peculiar  state, 
condition,  or  modification  of  the  atmosphere,  whether 
with  or  without  other  meteorological  phenomena 
referrable  to  the  air  and  the  soil,  does  occasionally 
result  in  the  prevalence  of  disease  over  certain  dis- 


TREATISE  ON  EPIDEMIC  CHOLERA. 


27 


tricts  of  country.  And  it  is  equally  well  known  that 
the  disease  thus  superinduced  bears  a  striking  resem- 
blance in  each  individual  case,  and  that  these  cases 
often  multiply  until  scarcely  a  family  or  individual 
escapes  more  or  less  of  its  influence.  When  only  a 
small  section  of  a  city  or  neighbourhood  is  thus  visit- 
ed, while  other  adjacent  sections  are  entirely  exempt, 
we  attribute  it  to  some  local  cause  capable  of  affect- 
ing only  the  atmosphere  in  its  immediate  vicinity, 
and  we  call  such  diseases  endemical  or  endemics.  But 
when  the  whole  of  a  city  and  parts  adjacent,  or  a 
larger  district  of  country,  is  involved  in  the  visitation, 
we  say  they  are  epidemics.  In  what  this  obnoxious 
something  in  the  air  consists,  this  blight,  poison,  or 
whatever  it  may  be  called,  is  a  problem  yet  un- 
solved, and  for  the  obvious  reason,  that  its  exist- 
ence is  not  cognizable  by  the  senses,  nor  can  it  be 
detected  by  analysis,  but  is  known  only  by  its  effects. 

All  these  endemics  or  epidemics  are  viewed' by  the 
uninformed  as  contagious  or  catching,  and  for  no 
other  earthly  reason,  than  because  several  members 
of  the  same  family  are  affected  at  or  near  the  same 
time.  This  was  once  the  fact  among  the  common 
people  when  intermittents  or  agues  and  fevers  first 
began  to  prevail ;  they  were  deemed  catching  or  con- 
tagious; and  were  such  attacks  equally  fatal  with 
Cholera,  they  would  still  excite  equal  consternation 
in  new  settled  countries,  and  cause  the  like  abandon- 
ment of  relatives  and  friends. 

By  the  term  contagion,  however,  physicians  under- 
stand a  disease  communicable  from  a  sick  to  a  healthy 
body  by  contact,  and  of  course  transmissible  to  any 


28 


TREATISE  ON  EPIDEMIC  CHOLERA. 


distance  by  persons  or  things,  such  as  small  pox ;  for 
example,  which  is  a  contagious  fever.  Among  the 
distinct  characteristics  of  such  fevers,  the  three  fol- 
lowing may  he  considered  most  prominent : 

1st.  They  arise  from  no  other  source  than  conta- 
gion. This  is  invariable;  and  hence,  if  a  contagious 
fever  could  be  once  exterminated  from  the  earth, 
its  re-appearance  would  be  impracticable  from  any 
known  cause. 

2d.  They  attack  but  once  during  life,  and  the 
subject  is  ever  after  free  from  a  return,  however 
much  exposed.  The  exceptions  to  this  rule  are  so 
few  and  far  between,  that  they  do  not  invalidate  the 
general  rule,  but  rather  prove  it. 

3d.  They  are  capable  of  being  communicated  by 
engrafting  or  inoculation ;  and  this  is  the  case,  not 
only  with  fevers  of  this  class,  but  even  with  local 
diseases  which  are  contagious,  as  small  pox,  cow 
pox,  (fee.  This,  therefore,  plainly  distinguishes  con- 
tagious from  infectious  epidemics,  for  the  latter  can- 
not be  inoculated,  having  been  tried  with  Cholera, 
Yellow  Fever,  and  many  others. 

Now,  as  neither  of  these  constituents  of  a  conta- 
gious fever  are  found  to  be  true  of  Cholera,  there  can 
be  no  foundation  for  regarding  it  as  contagious. 

But  the  term  infection  is  one  often  confounded  with 
contagion,  and  for  want  of  the  necessary  discrimina- 
tion here,  much  ambiguity  has  been  created  on  this 
subject.  A  contagious  disease  may  be  justly  denomi- 
nated infectious,  but  a  disease  strictly  infectious  can- 
not possibly  be  contagious.  All  endemics  and  epi- 
demics are  said  to  be  infectious ;  by  which  term  we 


TREATISE  ON  EPIDEMIC  CHOLERA. 


29 


mean  that  the  district  of  country  suflfering  under 
them  is  infected  by  the  cause  whence  they  originate. 
For  example,  a  neiglihourhood  is  labouring  under  the 
prevalence  of  ague  and  fever,  and  the  air  is  so  infect- 
ed with  the  cause  of  this  malady,  that  most,  if  not 
all,  of  those  who  visit  it  in  health,  contract  the  dis- 
ease. But  the  diseased  person,  or  any  number  of 
such,  may  be  removed  into  a  healthy  neighbourhood, 
and  they  cannot  infect  the  air,  nor  can  any  or  all  of 
them  propagate  the  malady  to  others  who  have  not 
been  within  the  infected  district.  This  is  the  case 
with  nearly  all  our  vernal  and  autumnal  epidemics, 
such  as  bilious,  intermittent,  remittent,  and  malignant 
fevers.  Hence  they  are  no  longer  viewed  as  conta- 
gious, and  quarantine  regulations  to  prevent  their  in- 
troduction are  now  nearly  exploded  in  every  enlight- 
ened country. 

But  although  we  know  enough  of  these  and  kin- 
dred epidemics  to  abjure  all  apprehension  of  their 
contagion ;  and  although  they  are  now  every  where 
regarded  as  strictly  atmospheric,  and  their  origin 
traced  to  exhalations  from  the  decomposition  of  ani- 
mal or  vegetable  substances,  under  the  combined  in- 
fluence of  moisture  and  heat ;  and  although  barome- 
trical and  meteorological  science  has  thrown  some 
light  on  the  cause  and  causation  of  these  maladies ; 
yet  the  precise  nature  of  this  miasma,  malaria,  or 
whatever  it  may  be  called,  has  hitherto  baffled  in- 
vestigation, and  seems  to  defy  our  scrutiny.  Still, 
however,  we  know  enough  of  its  modus  agendi  to 
assist  us  in  detecting  and  removing  the  sources  whence 
it  originates,  and  in  controlling  and  removing  its 


30  TREATISE  ON  EPIDEMIC  CHOLERA. 

effects  upon  the  pul:)lic  health,  by  the  appropriate 
means  withhi  the  power  of  enlightened  science;  and 
this  Icnowledge,  imperfect  as  it  is,  has  every  where 
diminished  the  severity  and  fatality  of  such  epi- 
demics, as  well  as  prevented  their  more  frequent  re- 
currence. 

That  there  are  several  striking  points  of  analogy 
between  the  several  epidemics  so  familiar  to  us  in  Ame- 
rica, and  the  Cholera  of  the  last  season,  as  it  prevail- 
ed among  us,  must  have  been  obvious  to  all  who  have 
made  observations  upon  the  one  and  the  other.  The 
peculiarity  of  the  previous  season,  the  alternate  heat 
and  moisture  of  the  air  and  surface  of  the  earth,  the 
unusual  influx  and  reflux  of  the  tides,  have  one  or 
all  been  remarked  in  every  place.  The  great  preva- 
lence and  spread  of  the  disease  in  those  sections  of 
different  cities  where  intermittents  and  remittents 
are  usually  common,  and  the  almost  entire  exemption 
of  those  sections  which  had  been  cleansed,  ventilated, 
and  filled  up,  to  prevent  the  recurrence  of  yellow 
fever  where  it  had  formerly  appeared,  as  in  the  first 
ward  of  New  York,  and  Fell's  Point  in  Baltimore, 
are  facts  which  are  too  obvious  to  escape  notice,  and 
which  are  strongly  corroborative  of  this  analogy. 
Besides  the  sudden  disappearance  of  the  Cholera  on 
the  first  frosty  as  seen  in  Canada,  in  our  several  cities, 
and  especially  in  New  Orleans,  cannot  fail  to  remind 
us  of  its  similarity,  in  this  respect,  with  the  Yellow 
Fever  and  our  other  autumnal  epidemics.  And  the 
still  more  striking  fact,  that  the  Yellow  Fever  appear- 
ed in  New  Orleans,  as  usual,  during  the  last  season, 
and  was  soon  followed  by  the  Cholera,  both  diseases 


TREATISE  ON  EPIDEMIC  CHOLERA. 


31 


for  a  time  raging  together;  and  in  a  more  concentra- 
ted state  of  the  morbific  cause,  the  former  giving  place 
to  the  latter;  are  circumstances  which  go  very  far  to 
show  that  both  diseases  originated  from  the  same 
cause,  ditfering  only  in  the  degree  of  its  intensity. 

Besides  these  several  points  of  resemblance,  the 
particular  locations  in  which  the  Cholera  exhibited 
its  most  appalling  features,  and  resulted  in  the  most 
signal  fatality,  in  every  city  where  it  prevailed,  de- 
monstrated very  clearly  that  its  origin  was  to  be  tra- 
ced altogether  to  local  causes.  Witness  the  localities  of 
the  Five  Points,  Corlaer's  Hook,  Laurens-street,  Har- 
lem, (fcc.  in  New  York  ;  and  similar  facts  were  exhi- 
bited in  the  neighbourhood  of  the  Brick-Yards  at 
Philadelphia;  Ruxton  Lane,  in  Baltimore;  and  on 
the  line  of  the  Canal,  near  Washington,  D.  C.  Wit- 
ness also  the  memorable  mortality  at  the  Alms-house 
at  Poughkeepsie,  Bellevue  in  New  York,  and  the  Arch- 
street  prison,  Philadelphia.  All  these  are  so  many 
clear  and  convincing  arguments  in  favour  of  the  fact, 
that  the  exhalations  from  filthy  and  ill-ventilated 
streets,  alleys,  and  houses,  and  those  from  crowded 
apartments  where  personal  cleanliness  or  wholesome 
fare  is  neglected,  absolutely  originated  the  malady, 
and  also  gave  it  its  alarming  character. 

From  these  and  other  similar  facts,  it  must  be 
apparent  that  the  predisposition  to  Cholera  was  su- 
perinduced from  atmospheric  causes,  as  in  our  other 
American  epidemics,  and  hence  more  or  less  of  pre- 
monitory symptoms  were  felt  by  nearly  all  of  those 
who  inhaled  the  vitiated  air  of  such  localities.  As  in 
others,  so  in  this  epidemic,  thousands  who  felt  this 


32 


TREATISE  ON  EPIDEMIC  CHOLERA. 


predisposition  for  days,  and  even  weeks,  escaped  the 
onset  of  the  disease  by  avoiding  its  exciting  causes ; 
while  others,  though  unconscious  of  the  predisposi- 
tion, suddenly  fell  its  victims  without  a  single  pre- 
monitory symptom,  perhaps  by  some  excess,  or  in 
some  few  instances  without  any  overt  imprudence, 
although  such  cases  were  exceedingly  rare. 

Among  the  exciting  causes  to  which  sudden 
and  alarming  attacks  of  Cholera  were  attributed, 
very  many  articles  of  diet  and  drink  have  been 
named ;  and  indeed  many  of  the  proscribed  articles 
were  almost  invariably  followed  by  its  visitation  in 
however  small  quantities  they  w^ere  used.  In  ge- 
neral, however,  it  may  be  remarked,  that  it  was  not 
owing  to  any  specific  or  poisonous  quality  of  the 
fruits  or  vegetables  eaten,  but  to  their  indigestible 
character;  and  hence  many  of  the  victims  of  the  dis- 
ease were  rigidly  scrupulous  in  abstaining  from 
every  thing  which  was  proscribed  as  hurtful  by  any 
authority.  Some  of  the  worst  cases  in  New  York 
were  of  this  character;  and  occurring  in  persons 
strictly  temperate,  as  well  as  rigidly  abstinent  from 
the  supposed  causes  of  the  disease,  they  excited  much 
astonishment  and  alarm.  In  all  such  cases,  however, 
there  was  found,  on  careful  inquiry,  evidence  of  pre- 
vious derangement  of  the  digestive  organs  ;  and  in 
many  of  them  we  had  the  clearest  evidence  that  ani- 
mal food  had  been  eaten  in  a  quantity  greater  than 
the  stomach  was  capable  of  disposing  of;  and  as 
most  kinds  of  meat  were  strenuously  recommended, 
it  was  generally  eaten  more  freely  than  ordinary. 
A  majority  of  the  cases  occurring  among  the  tempe- 


TREATISE  ON  EPIDEMIC  CHOLERA. 


33 


rate,  under  my  own  observation,  were  found  to  be 
enormous  eaters  of  flesh. 

Observation  and  experience  clearly  demonstrated 
in  multiplied  instances  in  this  city,  (New  York^)  as 
elsewhere,  that  any  articles  of  food,  whether  animal 
or  vegetable,  undergoing  fermentation  or  putrefac- 
tion in  the  stomach,  were  exciting  causes  of  Cholera 
in  the  predisposed,  whether  with  or  without  premo- 
nitory symptoms.  And  as  these  processes  quickly 
follow  in  the  temperature  of  the  gastric  juice,  if 
digestion  does  not  overtake  the  food  soon  after  its  in- 
troduction into  the  stomach,  especially  in  the  debilita- 
ted state  of  that  organ  in  the  predisposed,  it  is  not  to 
be  wondered  at  that  Cliolera  should  be  excited  in 
such  persons,  either  by  a  quality  of  food  indigestible 
in  itself,  or  by  too  full  a  meal,  or  by  too  long  fasting, 
or  by  previously  existing  dyspepsia.  Facts  which 
are  familiar  to  physicians  experienced  in  the  disease, 
will  go  very  far  to  sustain  these  views  as  rational 
and  conclusive  ;  and  if  they  are  admitted^  many  of 
its  phenomena  are  accounted  for  which  are  otherwise 
inexplicable. 

The  following  table  exhibits  the  articles  of  food 
and  drink  which,  in  this  city,  were  distinctly  ob- 
served to  excite  the  attacks  of  Cholera  in  individual 
cases  among  the  predisposed.  They  are  placed  as 
nearly  as  possible  in  the  order  in  which  they  were 
observed  to  produce  this  result : 

Drinks  : 

Ardent  Spirits, 

Beer  and  Ale,, 

Wine. 

5 


34 


TREATISE  ON  EPIDEMIC  CHOLERA. 


Food  : 


Pork,  fresh  and  salt, 
Lobsters  and  Crabs, 
Green  Corn, 
Clams  and  Oysters, 
Watermelons, 
Cucumbers, 
Strawberries, 


Peaches  and  Pears, 

Blackberries, 

Cherries, 

Most  other  fruits, 

Beans  and  Peas, 

Cabbage  and  Greens, 

Cheese. 


Medicines  : 


Every  form  of  spirituous  liquors  and  fermented 

drinks, 
Opium,  in  any  form. 

Rhubarb,  Jalap,  and  other  drastic  cathartics, 
Nostrums  of  all  kinds. 

It  may  be  found  that  there  are  individuals  who 
continued  to  eat  and  drink  most,  and  perhaps  all  of 
these  articles  with  impunity ;  but  still,  it  is  the  fact, 
that  cases  occurred  almost  daily  so  immediately  after 
taking  each  of  them,  that  it  was  difficult  to  avoid 
the  impression  that  these  were  the  exciting  causes. 
Especially  was  this  the  case  if  these  articles  were 
eaten  or  drank  just  before  going  to  bed ;  and  a  full 
meal,  under  such  circumstances,  produced  an  attack 
before  morning,  in  numerous  instances,  however  sim- 
ple the  fare.  In  some  melancholy  instances,  a  little 
crackers  and  cheese,  with  a  glass  of  beer  or  wine, 
taken  before  retiring  at  night,  has  developed  the  dis- 
ease in  a  fatal  form  before  morning,  and  in  persons 
who  were  not  previously  sensibly  indisposed. 

The  fact  that  some  few  persons  continued  to  drink 
rum,  and  eat  pork  and  beans,  cucumbers,  waterme- 
lons, and  the  like,  through  the  whole  course  of  the 


TREATISE  ON  EPIDEMIC  CHOLERA. 


35 


disease,  without  suffering  an  attack,  are  to  be  re- 
garded as  extraordinary  escapes,  and  by  no  means 
render  it  safe  to  imitate  them,  when,  in  an  over- 
whelming majority  of  cases,  they  were  found  to  be 
so  mischievous.  And  on  a  recurrence  of  the  epidemic, 
therefore,  prudence  will  dictate  that  we  avoid  those 
articles  which  experience  has  taught  to  be  pernicious 
and  unsafe. 


III.  Of  the  Treatment  of  Cholera, 

Having  now  described  the  disease  in  its  various 
forms,  and  having  treated  of  its  remote  and  exciting 
causes,  the  reader  is  prepared  to  understand  the  re- 
medies which  are  to  be  recommended  for  its  remo- 
val, as  well  as  the  principles  on  which  those  reme- 
dies are  employed. 

When  Cholera  appears  in  any  place,  and  begins  to 
spread,  it  is  utterly  vain  to  remove  with  the  hope  of 
fleeing  from  the  disease.  The  remote  causes  which 
we  have  placed  in  the  air  have  already  excited  the 
predisposition  in  all  who  have  inhaled  it ;  and  how- 
ever rapidly  they  may  leave  the  city,  or  however  dis- 
tant they  may  flee,  they  carry  with  them  the  epi- 
demic constitution,  or  the  predisposition.  The  eff'ect 
is  already  produced  by  the  morbid  cause  upon  the 
brain  and  nervous  system ;  and  all  are  predisposed 
to  the  epidemic  who  live  within  the  atmosphere  of 
its  influence.  This  fact  should  be  well  understood, 
as  it  would  show  the  importance  of  prudence  and 


36 


TREATISE  ON  EPIDEMIC  CHOLERA. 


discretion  in  avoiding  the  exciting  causes,  as  well  as 
the  consummate  folly  of  removing  our  families,  espe- 
cially when  we  are  liable  to  suffer  an  attack  after 
we  have  gained  a  location  free  from  the  epidemic 
influence,  and  at  the  same  time  beyond  the  most  ju- 
dicious means  of  relief.  Very  many  have  fallen  vic- 
tims to  the  disease  by  removal,  who,  had  they  re- 
mained at  home,  might  probably  have  altogether  es- 
caped an  attack.  Persons  who  remove  without  re- 
membering that  already  they  have  become  predis- 
posed by  exposure  to  the  cause,  throw  off  all  re- 
straint, and  live  as  though  they  were  safe  from  the 
disease.  They  therefore  suffer  an  attack  which 
might  have  been  prevented  by  judicious  precau- 
tion ;  and  being  frequently  distant  from  medical 
aid,  are  beyond  hope  before  physicians  can  be  pro- 
cured. Such  instances  were  by  no  means  rare  the 
last  summer,  and  ought  to  serve  as  a  salutary  lesson 
on  the  recurrence  of  the  epidemic. 

This  epidemic  constitution  or  predisposition,  how- 
ever, may  present  no  sensible  signs,  although  its  ex- 
istence is  certain  in  all  the  inhabitants  of  a  neigh- 
bourhood or  city  where  the  Cholera,  or  any  similar 
epidemic,  begins  to  prevail.  In  some  cases,  however, 
it  may  be  recognized  by  a  sensation  of  debility  and 
indisposition  to  motion,  of  which  many  were  con- 
scious in  New  York,  not  only  before  any  premonito- 
ry symptoms  had  appeared,  but  before  there  were 
any  apprehensions  of  Cholera  either  felt  or  express- 
ed in  the  city,  and  certainly  before  its  existence 
here  was  certain.  It  may  have  existed  for  weeks 
prior  to  the  irruption  of  the  epidemic,  and  may  ac- 


TREATISE  ON  EPIDEMIC  CHOLERA. 


37 


count  for  many  modifications  of  other  diseases,  wliich 
were  deemed  by  physicians  as  unusual  and  inexplica- 
blo.  Indeed,  the  intestinal  irritation  and  morbid  ex- 
cretions, so  familiar  in  the  prevalence  of  the  Cholera, 
Jiad  attracted  the  attention  and  elicited  the  remark 
of  many  discriminating  physicians  for  six  weeks  be- 
fore the  Cholera  was  reported  as  here,  and  these 
symptoms  were  often  troublesome  and  sometimes 
fatal  in  May  and  June,  in  other  and  distinct  diseases. 
And  although  we  could  not  then  predict  the  spread 
of  the  epidemic,  yet,  on  any  future  season,  these  signs 
would  be  regarded  as  premonitory  of  a  visitation. 

But  it  may  be  remarked  that,  however  manifest 
the  predisposition,  even  by  sensible  signs,  such  as 
those  we  have  named,  the  disease  may  be  altogether 
avoided  by  carefully  abstaining  from  the  exciting 
causes.  And  should  this  epidemic  constitution  be 
still  more  clearly  manifest  by  the  appearance  of  pre- 
monitory symptoms,  yet  still  it  is  by  no  means  cer- 
tain that  an  attack  will  supervene,  if  prudent  mea- 
sures be  adopted  and  pursued. 

To  the  predisposed,  including  all  the  inhabitants 
of  the  region  where  the  epidemic  has  commenced  its 
ravages,  I  would  recommend  the  following  rules  : 

1st.  Let  care  be  taken  to  avoid  all  unnecessary  ex- 
posure, especially  to  the  night  air ;  let  the  feet  be 
kept  dry  and  warm,  and  the  skin  protected  by  flan- 
nel, changed  twice  at  least  in  the  week. 

2d.  Let  an  entire  change  be  adopted  in  the  quaii- 
tity  of  food  taken  into  the  stomach,  as  well  as  its 
quality.  The  articles  eaten  should  be  such  as  are 
jeasy  of  digestion,  and  all  of  these  very  moderately. 


38 


TREATISE  ON  EPIDEMIC  CHOLERA. 


A  full  meal  will  often  bring  on  an  attack,  whatever 
be  the  kind  of  food  taken. 

3d.  Avoid  all  undue  excitement,  whether  physical 
or  mental ;  any  exertion  long  continued,  and  espe- 
cially to  fatigue,  will  frequently  prove  an  exciting 
cause.  Hard  labour,  close  study,  or  an  indulgence  of 
the  exciting  passions  of  the  mind,  must  be  carefully 
abstained  from. 

4th.  Above  all  things,  take  no  medicines  as  preven- 
tives, by  whomsoever  recommended ;  and  especially 
no  vinous,  spirituous,  or  malt  liquors.  Any  stimu- 
lant, of  whatever  kind,  habitually  used,  even  in  mo- 
deration, is  found  to  give  a  predisposition  to  all  epi- 
demic diseases,  and  especially  to  Cholera,  frequently 
becoming  the  exciting  cause  of  the  most  desperate  and 
unmanageable  attacks. 

5th.  Preserve  a  calm  composure  of  mind,  as  far  as 
possible,  and  indulge  a  confident  security  of  immu- 
nity from  an  attack  while  you  thus  avoid  the  exci- 
ting causes.  The  depressing  passion  of  fear,  when 
cultivated,  often  excites  the  disease. 

But  to  those  who  are  attacked  with  what  are  call- 
ed "  premonitory  symptoms,"  which  most  frequently 
arise  after  some  imprudence,  I  would  recommend 
that  they  view  the  diarrhoea,  not  in  the  light  of  an 
attack  of  Cholera,  but  as  an  admonition  that  they 
have  erred  in  subjecting  themselves  to  some  exciting 
cause,  and  that  they  are  now  liable  to  an  attack. 
And  as  nature  has  aroused  for  its  own  protection, 
let  them  on  no  account  interrupt  or  suppress  this 
salutary  process  by  astringents,  tonics,  or  stimu- 
lants, of  any  kind  ;  and,  above  all,  avoid  opium, 


TREATISE  ON  EPIDEMIC  CHOLERA. 


39 


brandy,  or  wine,  as  you  would  shun  the  face  of  a 
serpent. 

If  there  be  any  considerable  nausea  or  vomiting  pre- 
sent at  the  commencement  of  the  diarrhoea,  or  if  these 
precede  it,  drink  half  a  pint  of  salt  and  water,  go  to 
bed,  apply  a  bottle  of  hot  water  to  your  feet,  and  pro- 
mote a  gentle  perspiration.  The  effect  of  the  salt 
and  water  will  be,  that  you  will  vomit  the  contents 
of  your  stomach,  and  a  slight  purgation  will  follow. 
If  you  are  not  then  entirely  relieved,  you  may  find 
it  necessary  to  take  15  grains  of  calomel,  and  per- 
haps follow  it  in  four  hours  with  an  ounce  of  castor 
oil.  If,  in  the  mean  time,  you  eat  nothing,  and 
drink  cold  water  only,  your  premonitory  symptoms 
will  be  over,  and  all  hazard  of  an  attack  is  re- 
moved. 

But  if  you  have  been  living  abstemiously,  you  will 
have  little  nausea  at  first,  and  you  may  take  therefore 
15  or  20  grains  of  calomel  at  once,  and  alone.  This 
done,  will,  in  ninety-nine  cases  in  a  hundred,  fully 
answer  the  purpose,  if  aided  by  the  recumbent  pos- 
ture, and  the  other  means  mentioned  in  the  last  para- 
graph, and  the  appearance  of  bile  in  the  discharges 
will  give  evidence  that  the  danger  is  over.  It  is 
sometimes  necessary,  however,  to  repeat  the  dose  of  ca- 
lomel, and  even  follow  it  with  oil,  if  the  diarrhoea  have 
existed  for  any  length  of  time,  and  been  neglected. 

If  it  have  been  neglected  too  long,  and  with  the 
diarrhoea  there  be  a  tightness  in  the  chest  felt  on 
breathing,  or  any  increase  of  the  spasmodic  twitching 
of  the  muscles  has  supervened ;  and  especially  if  the 
calomel  does  not  have  its  desired  effect,  and  the  cha- 


40 


TREATISE  ON  EPIDEMIC  CHOLERA. 


racteristic  discharges  continue  notwithstanding;  then 
the  patient  should  be  bled.  Indeed,  so  important  is 
this  course,  that,  as  an  auxiliary  to  the  calojnel,  it 
should  be  pursued  in  all  violent  cases.  Professor  Sew- 
all,  of  Washington,  D.  C,  directed  all  thecasesof  "pre- 
monitory symptoms,"  among  the  labourers  on  the 
canal,  to  be  bled,  with  the  other  appropriate  treatment 
we  have  named,  and  although  a  signal  fatality  had 
previously  occurred,  not  a  single  death  took  place  from 
the  day  on  which  the  bleeding  practice  was  commen- 
ced. My  own  experience  has  fully  tested  the  pro- 
priety of  this  course,  nor  do  I  recollect  a  single  case 
treated  by  me  in  the  premonitory  symptoms  by  bleed- 
ing and  calomel,  which  was  my  usual  practice,  which 
afterwards  suffered  an  attack  of  the  disease,  although 
many  of  them  had  been  neglected  and  were  violent 
when  I  saw  them.  A  few  hours  after  the  bleeding, 
the  bilious  discharges  from  the  bowels  following  a 
single  dose  of  calomel,  gave  evidence  of  the  entire  re- 
moval of  the  morbid  action;  and  all  the  symptoms 
immediately  subsided. 

Nearly  all  the  cases  of  mortality  in  New  York,  oc- 
curred among  those  who  had  neglected  the  premoni- 
tory symptoms,  or  what  is  worse,  had  treated  them  by 
opium  and  brandy.  We  except,  of  course,  the  few  in- 
stances which  came  on  suddenly,  without  any  premo- 
nition. These,  therefore,  were  generally  in  the  stage 
of  collapse  or  asphyxia,  as  it  is  called,  sometimes  the 
blue  stage,  and  which  has  been  minutely  described 
in  a  previous  chapter.  This  was  the  condition  of 
most  of  those  who  were  carried  to  our  hospitals,  and 
whatever  may  be  thought  of  the  treatment  generally 


TREATISE  ON  EPIDEMIC  CHOLERA. 


41 


pursued  in  those  of  this  city,  and  whatever  has  been 
said  of  the  fatality  occurring  in  them,  it  is  but  com- 
mon justice  that  it  sliould  be  known,  that  a  large  ma- 
jority of  the  patients  sent  to  the  hospitals  had  been  for 
hours  in  this  blue  stage  or  collapse,  before  their  ad- 
mission. And  when  the  additional  fact  is  remem- 
bered, that  most  of  these  were  dissolute,  filthy,  and 
drunken  subjects,  the  mortality  will  cease  to  be  won- 
derful, and  it  will  rather  be  matter  of  astonishment 
that  an3^  such  were  cured  by  any  treatment.  Though 
unconnected  with  either  of  the  public  establishments, 
and  although  I  strongly  reprobate  the  plan  of  treat- 
ment pursued  in  some  of  them,  yet  it  is  due  to  truth, 
that  these  important  facts  should  be  known  and  ap- 
preciated ;  and  the  gentlemen  concerned  are  entitled 
to  this  exhibition  of  facts,  in  any  strictures  which  are 
made  upon  them  or  their  hospital  practice. 

The  symptoms  characteristic  of  this  stage,  are 
those  of  Cholera,  and  any  previous  or  subsequent 
symptoms,  possess  no  diagnostic  character  by  which 
they  can  be  certainly  distinguished  from  analogous 
symptoms,  occurring  in  other  diseases.  When  these 
are  present,  therefore,  or  a  majority  of  them,  I  regard 
the  case  as  well  marked,  and  the  condition  of  the 
patient  presents  to  my  mind,  a  state  of  congestiox, 
which,  unless  removed,  must  infallibly  be  fatal  in  a 
few  hours.  Upon  this  view  of  the  subject,  my  treat- 
ment of  Cholera  has  been  founded,  and  I  should  there- 
fore have  pursued  it,  if  it  had  never  been  proposed  or 
tried  before  me  :  and  I  would  have  carried  depletion 
to  the  same  extent  to  which  I  have  ever  used  it,  if  no 
medical  authority  upon  earth  had  existed  to  sustain 
6 


42 


TREATISE  ON  EPIDEMIC  CHOLERA. 


me.  Indeed,  the  admission  tliat  it  is  a  disease  of  con- 
gestion, would  lead  any  mind  to  the  same  conclusions 
and  practice.  Accordingly,  some  of  the  best  autho- 
rities on  this  subject  are  directly  in  point,  and  amply 
sustain  the  bold  and  energetic  treatment  for  which 
I  contend,  and  the  triumphant  results  of  which  I  had 
the  happiness  of  witnessing  in  my  own  practice,  and 
also  in  the  hands  of  others  equally  successful. 

In  these  symptoms,  therefore,  my  chief  reliance  is 
on  the  lancet,  and  I  prefer  this  to  leeching  or  cupping, 
although  both  have  found  advocates,  and  both  may 
be  useful,  but  only  as  auxiliaries,  if  the  congestion  be 
as  great  as  that  we  witnessed  in  the  cases  here.  The 
treatment  of  this  condition  of  the  system  ought  to 
begin  by  a  full  bleeding,  to  be  repeated  as  often  as 
the  circumstances  demand,  and  this  will  often  be 
three  or  four  times  in  the  course  of  twelve  hours. 

My  next  remedy,  in  point  of  order  and  importance, 
is  Calomel,  in  doses  of  twenty  or  thirty  grains,  to  be 
repeated  every  two,  three,  or  four  hours,  according 
to  the  urgency  of  the  symptoms.  And  this  agent  I 
employed  alone,  uncombined  with  opium  or  any  other 
auxiliary. 

On  opening  the  vein  in  these  cases,  the  blood  will 
be  found  nearly  of  the  colour  and  consistence  of  tar, 
and  will  flow  only  by  drops,  and  often  requires  to  be 
forced  by  mechanical  means.  In  such  cases,  if  ex- 
ternal heat  and  frictions  to  the  surface  of  the  body 
did  not  succeed,  I  adopted  the  expedient  often  used  in 
other  congestive  diseases,  of  exhibiting  ice  internally, 
small  pieces  being  rapidly  swallowed.  This  plan 
never  once  failed  me,  and  by  it  I  could  obtain  the 


TREATISE  ON  EPIDEMIC  CHOLERA. 


43 


quantity  of  blood  which  the  emergency  called  for, 
thus  unlocking  the  oppressed  circulation.  Very  soon 
I  found  the  ice  indispensable  to  control  the  vomiting, 
and  have  often  succeeded  thereby  in  allaying  the 
thirst  without  drinks,  and  controlling  a  stomach  so 
incorrigible  that  it  resisted  all  the  other  remedies 
usually  employed. 

The  importance  of  this  quick  and  plentiful  ab- 
straction of  blood  arises  from  its  accumulation  in  the 
internal  and  larger  vessels,  which  constitutes,  as  we 
have  said,  the  very  essence  of  the  disease.  This  ac- 
cumulation, together  with  the  profuse  discharges  of 
the  watery  part  of  the  blood,  prepares  the  congested 
mass  for  coagulation,  to  which  the  state  of  rest,  in 
which  asphyxia  results,  disposes  it.  The  effect  of 
this  congestion  upon  the  circulating  mass,  first  affects 
the  liver  by  reason  of  its  peculiar  organization,  and 
the  absence  of  bile  in  the  passages,  is  to  be  attributed 
to  a  spasm  in  the  ducts  leading  from  the  liver  and 
gall-bladder  into  the  intestinal  canal,  an  opinion  which 
dissection  abundantly  confirms.  By  large  and  repeat- 
ed bleeding,  a  change  is  not  only  effected  upon  the 
circulation,  and  the  blood  thereby  prevented  from  rest, 
which  favours  its  coagulation  :  but  a  relaxation  of  the 
extreme  vessels,  as  well  as  of  the  ducts  and  ureters 
affected  with  spasms,  often  resulted  in  the  worst  cases, 
where  sufficient  blood  could  be  draw^n,  in  an  imme- 
diate secretion  of  bile  and  urine,  as  well  as  the  re- 
storation of  warmth  to  the  surface,  which  before  had 
been  colder  than  that  of  a  corpse.  Indeed,  I  have 
several  times  heard  the  patient  say,  I  am  getting 
warmer  while  the  blood  flows,''  when  the  coldness 


44 


TREATISE  ON  EPIDEMIC  CHOLERA. 


had  been  sensible  to  himself,  and  inquire  the  cause 
of  what  seemed  to  him  so  singular  a  phenomenon. 
Another  important  result  of  bleeding,  as  manifest  in 
this  as  in  other  diseases,  was,  that  it  rendered  the 
subsequent  remedies  ethcient ;  for  in  many  cases 
where  bleeding  was  not  premised,  neither  calomel 
nor  any  other  medicine  had  its  appropriate  effect,  in 
however  large  doses  they  were  given. 

I  know  that  many  have  objected  to  bleeding  where 
the  skin  is  cold,  and  the  pulse  is  extinct ;  because 
they  have  not  the  signs  present  in  other  diseases,  and 
supposed  to  alTord  indications  which  infallibly  dic- 
tate its  propriety.  And  some  physicians  have 
brought  this  practice  into  disrepute,  by  bleeding 
timidly  and  with  a  sparing  hand;  and  because  no 
sensible  effect  is  produced  by  four  or  five  ounces 
being  drawn,  they  hastily  close  the  vein,  and  let  the 
patient  die  a  victim  to  their  superstitious  fears.  They 
forget  that  the  symptoms  are  those  of  indirect  debi- 
lity, and  that  so  far  from  apprehending  that  they  will 
weaken  the  patient,  if  the  bleeding  result  in  direct 
debility,  their  patient  is  safe. 

The  names  of  Johnson,  Scott,  and  Ennesly,  are 
familiar  to  all  who  have  studied  the  history  of  Cho- 
lera, and  the  comparative  merits  of  the  various 
plans  of  treatment  pursued  by  Asiatic  and  Indian 
practitioners.  These  gentlemen  had  undoubtedly  the 
best  opportunities  of  judging  on  this  subject,  and  they 
unite  in  their  testimony  to  the  importance  and  ne- 
cessity of  blood-letting. 

Dr.  Ennesly  says,  that  "  the  blood  on  opening  a 
vein  is  at  first  thick,  black,  and  comes  away  in 


TREATISE  ON  EPIDEMIC  CHOLERA. 


45 


drops ;  at  length  it  becomes  thinner,  and  flows  with 
more  ease,  till  the  colour  changes  to  a  bright  red. 
This  is  a  change  which  should  be  always  looked  for; 
and  whether  it  takes  place  after  the  abstraction  of 
one  ounce  or  thirty,  is  of  no  consequence;  that 
change  must  take  place  before  the  patient  can  be 
saved.'"'  He  adds,  If  blood-letting  has  not  uni- 
formly been  followed  by  favourable  results,  it  will  be 
found  to  have  failed  most  frequently  when  practised 
by  timid  hands;  where  small  quantities  have  been 
taken ;  such,  for  instance,  as  might  be  yielded  by 
remote  branches  of  vessels  ;  but  if  the  evacuation  be 
carried  till  its  effects  reach  the  internal,  vessels  and 
the  heart  itself,  then  the  circulating  system  will  be 
freed  from  an  oppression  which  impeded  its  func- 
tions, and  it  becomes  equal  to  the  task  of  propelling 
the  mass  of  blood." 

Dr.  Scott,  when  speaking  on  this  subject,  remarks, 
"  It  requires  no  common  effort  of  reasoning  or  reflec- 
tion to  arrive  at  the  conclusion,  that  when  the  pow- 
ers of  life  appear  depressed  to  the  lowest  degree, — 
the  pulsation  of  the  heart  all  but  extinct, — the  natu- 
ral heat  of  the  body  gone, — the  functions  of  the  sys- 
tem suspended,  and  incapable  of  being  revived  by  the 
strongest  stimulants — the  abstraction  of  blood  should 
yet  prove  a  remedy  against  a  train  of  symptoms  so 
desperate.  Indeed,  blood-letting,  in  the  more  aggra- 
vated forms  of  the  disease,  is  a  remedy  so  little  indi- 
cated by  the  usual  symptoms,  thoA,  its  employment 
in  the  cure  of  this  fatal  disease  must  be  regarded  as 
aff'ording  a  signal  triumph  to  the  medical  art." 

Dr.  Johnson  was  probably  the  first  who  tested  this 


46 


TREATISE  ON  EPIDEMIC  CHOLERA. 


practice,  to  which  he  was  led  by  the  obvious  venous 
congestions  which  dissection  presented,  and  by  the 
uniform  fatality  of  every  modification  of  stimulation 
which  has  ever  been  employed.  It  was  the  result  of 
reasoning  and '  reflection  originally,  but  his  experi- 
ence in  India  has  confirmed  its  propriety,  safety,  and 
success. 

Bleeding,  therefore,  ought  to  be  undertaken  in  such 
cases  with  the  full  persuasion,  that  if  we  succeed  in 
obtaining  a  sufficient  quantity,  the  patient  may  be 
saved  ;  and  friction,  bathing  the  arms  in  warm  wa- 
ter, opening  veins  or  arteries,  if  necessary,  and  the 
internal  exhibition  of  ice,  as  well  as  rubefacient  ap- 
plications, and  heat  to  the  external  surface,  should 
all  be  employed  as  auxiliaries  if  necessary.  Dr. 
Scott  directs,  that  the  physician  must  not  desist  by 
any  intermediate  accession  of  debility  or  collapse,  nor 
tempted  to  rest  satisfied  with  any  temporary  meli- 
oration of  pulse ;  his  object  goes  beyond  the  present 
moment,  and  he  feels  confident,  that  if  he  can  fully 
unload  the  internal  vessels,  he  will  save  his  patient, 
and  if  he  fails,  he  will  most  probably  lose  him." 

These  authorities  are  referred  to  with  the  design 
of  showing  that  the  extensive  depletion  which  has 
been  recommended,  even  in  the  cold,  collapsed,  or 
blue  stage,  is  not  novel  and  unheard  of,  even  in  this 
epidemic ;  and  with  the  hope  that  the  testimony  of 
Broussais  in  Paris,  and  those  who  have  proven  its 
success  here,  may  receive  confirmation,  and  that  none 
may  be  deterred  from  adopting  it,  even  in  the  most 
desperate  cases. 

I  have  dwelt  thus  long  upon  blood-letting  as  a  re- 


TREATISE  ON  EPIDEMIC  CHOLERA. 


47 


medy  in  Cholera,  because  I  believe  it  to  be  the  sheet- 
anchor  on  which  our  firmest  reliance  may  be  pla- 
ced. And  if  there  has  been  a  single  instance  of  re- 
covery from  well  characterized  Cholera  without 
blood-letting;  if  there  be  a  single  living  man  or  wo- 
man who  has  been  recovered  from  deep  collapse 
without  bleeding,  I  frankly  athrm  I  have  never  seen, 
or  known,  or  heard  credible  evidence,  of  such  an  in- 
stance, and  yet  hundreds  now  survive  after  the  whole 
train  of  symptom.s  had  subsisted  for  hours,  who  owe 
their  preservation  to  large  and  repeated  bleedings. 

Immediately  after  full  bleeding,  with  the  auxiliaries 
which  have  been  mentioned,  I  administer  uniformly 
a  full  dose  of  calomel,  as  stated  above,  of  twenty  or 
thirty  grains,  and  repeat  this  every  few  hours,  as 
the  emergency  demands,  following  it  by  purgatives 
or  enemas,  when  indicated,  though  this  was  but 
seldom.  For  the  relief  of  violent  and  obsthiate 
spasms,  I  have  w^itnessed  extensive  trials  of  external 
friction  by  hot  chalk,  lumps  of  ice,  flowers  of  sulphur, 
Cayenne  pepper,  cantharides,  the  moxa,  and  various 
other  powerful  agents,  applied  to  the  skin;  but  I  could 
never  attain  any  evidence  of  the  specific  virtues  of 
either  of  these  modes  of  practice ;  and  yet  I  never 
failed  in  controlling  and  removing  the  spasms  by 
copious  blood-letting,  even  when  all  these  and  large 
doses  of  opium  had  entirely  failed.  Of  other  reme- 
dies I  have  but  little  to  say,  as  I  cqnceive  them  all  of 
minor  importance.  The  mercurial  ointment,  with 
Cayenne  and  camphor,  I  have  often  used,  where  every 
effort  to  abstract  blood  has  been  abortive,  from  being 
undertaken  too  late  :  but  though  I  have  had  such  pa- 


48 


TREATISE  ON  EPIDEMIC  CHOLERA. 


tients  rubbed  incessantly  for  six  liours  over  the 
wliole  body,  it  has  not  succeeded  in  my  hands,  as  it 
is  said  to  liave  done  under  the  management  of  Dr.  Roe 
and  others.  Tlie  "  camphor  practice,"  as  it  is  called, 
I  have  seen  relied  upon  in  a  number  of  instances,  un- 
til the  patient  was  dead;  but  I  never  could  hazard  a 
dependence  upon  it  myself,  from  any  evidence  of  its 
usefulness  which  I  have  been  able  to  obtain. 

The  brandy  and  opium  plan  of  treatment,  I  fear- 
lessly affirm,  is  not  only  irrational  and  absard,  but 
uniformly  fatal.  Without  censuring  any  body,  I  may 
here  remark,  that  I  never  used  a  drop  of  ardent  spirits, 
either  externally  or  internally,  in  the  treatment  of 
Cholera,  nor  do  I  believe  that  it  has  been  used  with 
success  by  any  one.  That  I  have  seen  the  worst  re- 
sults from  the  internal  use  of  brandy  and  opium,  ad- 
ministered by  others,  is  one  of  the  most  painful  remi- 
niscences which  the  destroyer  has  left  behind  him,  and 
one  which  will  never  be  erased  from  my  memory. 
It  is  true,  that  the  patient  under  their  use,  or  that  of 
any  other  stimulus,  will  tell  you  that  he  is  getting  bet- 
ter all  the  while,  but  presently  die  of  apoplexy  of  the 
lungs  and  brain.  If  I  had  a  voice  which  could  be 
heard  throughout  the  land,  I  would  lift  it  up,  and 
warn  my  countrymen  of  the  fearful  consequences  of 
using  ardent  spirits  as  a  preventive  or  cure  of  Cholera. 

Finally,  with  respect  to  the  treatment  of  consecu- 
tive fever,"  or  the  stage  of  reaction,  I  have  but  little 
to  say,  for  the  reason  that  the  symptoms  and  treat- 
ment of  this  fever,  is  in  no  wise  different  from  simi- 
lar reaction  in  other  congestive  diseases,  and  has  no 
one  characteristic  of  Cholera.  In  the  hundreds  of  my 


TREATISE  ON  EPIDEMIC  CHOLERA. 


49 


own  patients,  I  never  saw  this  consecutive  fever  either 
protracted  or  dangerous,  if  the  necessary  depletion 
had  been  premised;  and,  indeed,  the  reaction  was  for 
the  most  part  readily  controlled.  The  only  exceptions 
to  this  statement  were  consequent  upon  imprudence, 
and  mismanagement  of  convalescence. 

I  have  thus  briefly  presented  all  that  I  consider  im- 
portant in  the  medical  management  of  this  formi- 
dable disease,  and  should  it  unhappily  revisit  us  as  an 
epidemic,  I  have  full  confidence  that  similar  success, 
to  that  I  have  witnessed,  will  follow  the  same  treat- 
ment, in  other  hands.  I  claim  no  merit  for  novelty, 
nor  pretend  to  any  exclusive  skill;  but  my  opinions 
are  the  result  of  much  reading  and  reflection — a  close, 
patient,  and  arduous  investigation  of  the  epidemic,  in 
its  eff'ects  upon  the  living  and  the  dead — and  confirmed 
by  an  experience  somewhat  extensive,  during  the  late 
visitation  of  this  cruel  scourge.  And  it  is  thus  sub- 
mitted to  the  public,  with  no  other  motive,  than  that 
my  experience  may  benefit  others  in  a  like  emergency. 


IT. —  On  the  Means  of  Prevention. 

If  the  views  I  have  taken  of  the  nature  and  causes 
of  the  Cholera  be  correct,  it  is  entirely  of  local  origin, 
and  the  liability  to  its  recurrence  as  an  epidemic  will 
depend  upon  the  existence  or  removal  of  the  local 
causes,  in  whatever  they  consist.  And  as  I  disclaim 
the  opinion  of  its  contagiousness  or  transmissibility 
by  persons  or  things,  it  is  obvious  that  no  apprehen- 
7 


50 


TREATISE  ON  EPIDE3IIC  CEIOLERA. 


sionsneedbe  indulged  of  its  importation  from  foreign 
countries  or  distant  places  ;  and  equally  so,  that  all 
quarantine  regulations  are  needless  and  absurd. 

In  this  remark,  I  refer,  of  course,  to  the  ridiculous 
restrictions  which  are  imposed  upon  the  crews,  pas- 
sengers, and  cargoes,  arriving  from  ports  where  the 
disease  prevails :  and  not  to  such  regulations  as  re- 
quire the  removal  of  bilge  water,  and  the  thorough 
cleansing  and  ventilation  of  vessels  on  their  arrival 
in  port.  These  are  justifiable,  especially  in  warm 
weather,  to  prevent  their  being  local  sources  of  the 
disease,  for  filth  is  not  less  pernicious  in  a  ship  than 
in  a  house.  But  for  these  purposes  a  few  hours  is  or- 
dinarily amply  sufficient,  and  can  by  no  means  autho- 
rize the  inconvenience  and  sacrifice  occasioned  by  a 
detention  of  weeks.  And  in  the  case  of  vessels  on 
board  of  which  Cholera  has  originated  or  occurred 
during  the  voyage,  the  same  processes  of  purification 
having  been  adopted  as  in  other  cases,  the  restrictions 
imposed  upon  the  passengers,  and  the  fumigation  of 
their  baggage,  is  both  unnecessary  and  cruel :  for  there 
never  has  been  any  evidence  in  India,  or  elsewhere,  that 
the  disease  has  been  communicated  from  a  sick  body 
after  being  removed  from  the  epiedmic  influence,  much 
less  being  transmitted  in  the  persons  of  the  healthy,  or 
by  the  removal  of  goods,  under  any  circumstances.  The 
whole  of  these  absurd  prohibitions  of  Cholera  are  un- 
worthy any  civilized  and  enlightened  country,  being 
solely  the  offspring  of  empiricism  and  superstition. 

If  the  remote  cause  of  Cholera  be  atmospheric,  or 
malarious,  as  is  now  acknowledged  to  be  the  fact 
with  other  epidemics,  and  if  the  miasma  or  malaria 


TREATISE  ON  EPIDEMIC  CHOLERA. 


51 


depend  upon  soil,  climate,  temperature  of  the  season, 
and  other  barometrical  phenomena,  it  is  obvious  that 
these  can  only  be  modified  or  counteracted,  when  the 
causes  of  the  infection  are  detected,  and  are  found  to 
be  capable  of  removal,  or  modification.  That  a  single 
extensive  m.arsh  or  pond  of  stagnant  water,  has  in 
certain  seasons  produced  an  epidemic  of  dangerous 
and  even  fatal  character,  has  been  frequently  obser- 
ved ;  and  that  the  filling  up  or  draining  of  the  one  and 
the  other,  has  entirely  annihilated  the  disease,  has 
been  often  repeated  and  long  known  in  this  and  in 
other  countries.  In  like  manner  the  existence  and 
prevalence  of  Cholera  have  been  arrested  by  similar 
means,  by  avoiding  the  remote  cause  or  removing 
beyond  its  influence.  Mr.  Pettigrew,  in  his  pamphlet 
on  Cholera,  has  instanced  a  skilful  manoeuvre  of  the 
Marquis  of  Hastings  while  in  ladia,  by  which  he 
put  an  end  to  the  devastation  produced  by  Cholera 
among  his  troops,  and  which  consisted  in  remo- 
ving his  men  fifty  miles  only  from  the  spot  they  oc- 
cupied, to  another  where  the  soil  was  dry  and  elevated. 
He  removed  both  the  sick  and  the  well ;  and  from  the 
day  they  pitched  their  tents  beyond  the  epidemic  at- 
mosphere, the  sick  convalesced,  and  the  healthy  es- 
caped the  disease.  Dr.  Granville,  of  London,  relates 
that  an  officer  high  in  rank  who  served  in  India,  as- 
sured him,  that  while  marching  with  his  regiment  in 
a  particular  direction,  it  had  often  happened  that  he 
was  told  that  the  soldiers  at  the  head  of  his  column 
had  been  attacked  witli  Cholera  ;  upon  which  he  in- 
variably altered  his  line  of  march,  sending  some  to  the 
right  and  some  to  the  left  of  the  road  they  had  occu- 


52 


TREATISE  ON  EPIDEMIC  CBOLERA. 


piedj  and  the  disease  no  longer  appeared  among  the 
soldiers. 

Without  multiplying  such  facts  as  thus  fully  prove 
the  non-contagiousness  of  Cholera,  and  conclusively 
show  that  the  cause,  whatever  it  is  in  its  essential 
nature,  is  of  local  origin,  and  limited  extent,  like  other 
epidemics;  I  proceed  to  remark,  very  briefly,  on  the 
means  necessary  and  proper  to  prevent  its  recurrence, 
as  an  epidemic,  in  this  city  and  country.  And  as  the 
city  of  New  York  was  one  of  the  nuclei,  around 
which  the  miasmatic  blight,  poison,  or  obnoxious 
something  in  tlie  air,  which  is  the  remote  cause  of 
Cholera,  did  prevail  during  the  months  of  July,  Au- 
gust, and  September  last,  I  shall  use  this  case  of  our 
own  city  as  an  illustration  of  my  remarks,  because 
wherever  similar  causes  have  existed,  similar  effects 
have  followed. 

Having  already  stated  that  the  epidemic  influence 
exhibited  itself  in  other  diseases,  in  this  city,  during 
the  months  of  May  and  June,  it  is  not  easy  to  state 
when  or  where  the  first  case  of  well  marked  Cholera 
was  known  to  occur.  A  very  great  panic  had  been 
spread  among  our  citizens  by  the  accounts  of  its  ra- 
vages in  Canada,  and  especially  was  this  panic  aug- 
mented by  the  commission  despatched  thither  by  our 
city  councils,  to  make  inquiries  on  the  subject.  Many 
of  our  citizens,  as  well  as  some  of  our  physicians, 
were  in  hourly  expectation  that  it  would  be  import- 
ed from  Canada  or  elsewhere,  and  were  watching  for 
its  appearance  with  a  commendable  diligence,  so  far 
as  their  motives  were  concerned,  and  with  a  zeal  as 
innocent  as  their  fears.    Whether  the  first  true  case 


TREATISE  ON  EPIDEMIC  CHOLERA. 


53 


was  found  in  Cherry-street,  or  Roosevelt-street,  near 
the  East  River,  or  in  Reed-street,  near  the  Nortli  River, 
whether  on  the  27th  of  June,  or  on  the  2d  of  July, 
is  not  material  for  our  purpose,  nor  is  it  possible  cer- 
tainly to  decide.  But  it  was  not  until  the  3d  of  July 
that  it  was  officially  announced  as  existing  in  the 
city,  and  when  thus  ascertained  to  exist,  we  may 
appropriately  inquire  what  parts  of  the  city  were 
affected,  and  what  was  the  character  of  the  patients. 
If  the  points  of  the  city  first  affected  were  those  at 
which  foreign  vessels  arrive,  or  emigrants  land  who 
come  by  the  way  of  Canada,  and  if  the  cases  were 
among  these  emigrants,  foreigners,  sailors,  or  their  fa- 
milies, then  we  have  some  evidence  that  it  originated 
in  contagion,  especially  if  it  spread  among  those  who 
had  intercourse  with  the  patients,  and  among  those 
alone.  But  if,  on  the  other  hand,  we  shall  find  that  a 
great  number  of  cases  appeared  simultaneously  in  dif- 
ferent and  distant  parts  of  the  city,  and  in  patients 
who  did  not  know  of  each  other,  and  could  have  had 
no  possible  intercourse;  and  if  it  shall  also  appear, 
that  these  cases  occurred,  and  were  at  first  altogether 
confined  to  the  malarious  parts  of  the  city;  and  that 
no  instances  of  persons  recently  arrived  from  infected 
places,  were  among  them ;  then  it  is  conclusively  de- 
monstrable, that  our  epidemic  was  of  local  origin. 
Such  are  the  facts,  as  they  are  known  and  attested  by 
all  who  have  thoroughly  investigated  the  subject. 

And,  beside  these  facts,  it  may  be  remarked,  that 
in  nearly  every  case  occurring  in  the  first  fortnight  of 
its  prevalence,  the  houses  were  small,  filthy,  and 
crowded  with  inhabitants,  and  the  intemperate  were 


54 


TREATISE  ON  EPIDEMIC  CHOLERA. 


its  first  victims  almost  without  exception.  The  lo- 
cations most  severely  affected  were  on  the  borders  of 
the  rivers,  where  the  ground  is  low  and  marshy,  as 
Roosevelt,  Cherry,  and  Water-street ;  at  the  foot  of 
Reed-street,  Diiane-street,  and  vicinity  ;  the  neigh- 
bourhood of  the  Five  Points,  the  house  in  Broad- 
street,  with  an  old  common  sewer  under  it,  in  which 
ten  fatal  cases  occurred ;  Laurens-street,  Corlaer's 
Hook,  Yorkville,  Harlem,  Bellevue,  and  Greenwich 
Village.  These  were  the  parts  of  the  city  where  the 
pestilence  raged  in  all  its  violence,  and  where  fatal 
cases  occurred  in  the  greatest  numbers;  so  that  for  a 
time,  it  has  been  properly  remarked,  that  we  suffered 
from  a  number  of  endemics,  rather  than  a  general 
epidemic.  As,  however,  the  morbid  cause  in  the  at- 
mosphere of  these  nuclei  accumulated  in  amount  and 
intensity,  it  seemed  to  mingle  from  these  several 
points,  each  of  which  was  a  focus,  whence  the  epide- 
m.ic  influence  seemed,  to  some  extent,  to  pervade  every 
part  of  the  city  and  its  vicinity.  Hence  individual 
cases  occurred  in  parts  of  the  city  the  most  remote 
from  these  locations,  proving  ti:at  the  predisposition 
was  general,  and  of  course  the  influence  of  the  remote 
cause  was  almost  universally  felt,  by  sensible  signs. 

It  is  worthy  of  remark  here,  that  the  locations  in 
which  its  ravages  Vv^ere  the  most  dreadful,  were  not 
only  malarious,  by  reason  of  being  near  to  filthy 
docks,  slips,  common  sewers,  and  frequently  being 
made  ground,  but  the  majority  of  the  inhabitants  at 
several  of  these  points  were  crowded  together  in 
filthy  apartments,  as  in  Laurens-slreet,  which  was 
significantly  denominated  "rotten  row;"  a  nam© 


TREATISE  ON  EPIDEMIC  CHOLERA. 


55 


which  denoted  the  physical  as  well  as  moral  condi- 
tion of  its  wretched  and  abandoned  inmates ;  and 
where,  in  the  neighbourhood  of  a  shigle  square  or 
block,  nearly  two  hundred  miserable  victims  perished 
in  a  few  days.  The  same  remark  applies  to  the  de- 
vastations at  that  notorious  horde  of  filth,  infamy,  and 
vice,  known  as  the  '-Five  Points,"  where  a  larger 
proportion  of  cases  occurred  within  a  circumference 
of  a  few  hundred  yards,  than  in  whole  wards  differ- 
ently circumstanced.  And  it  is  equally  wortliy  of 
remark,  that  of  the  three  thousand  licensed  grog 
shops  with  whicli  tills  city  is  disgraced,  nearly  half 
of  them  are  located  in  the  several  parts  of  the  city  we 
have  named,  as  having  suffered  most  from  the  pesti- 
lence. And  indeed,  there  is  probably  not  one  of 
all  the  three  thousand,  which  did  not  furnish  one  or 
more  cases  either  in  the  person  or  family  of  its  keep- 
er, or  among  its  daily  customers.  I  myself  wit- 
nessed a  number  of  such  examples,  and  those  too  in 
those  parts  of  the  city  where  there  were  the  fewest 
cases.  In  many  of  these  grog-shops,  the  disease 
assailed  its  victims  while  there,  and,  unable  to  leave 
the  premises,  they  were  carried  thence  to  the  hospi- 
tals, and  in  a  few  hours  to  the  grave.  One  of  the 
keepers,  after  such  a  scene  occurring  beside  his  coun- 
ter, closed  his  doors,  and  abandoned  the  traffic,  say- 
ing that  "the  road  from  his  shop  to  hell  was  too 
short;  he  could  almost  see  the  way  there,"  and  he 
has  since  changed  his  business.  The  experience  of 
our  Hospital  Physicians,  if  it  were  published  in  all 
its  loathsome  details,  would  furnish  facts  on  the  con- 
nexion between  Rum  and  Cholera,  and  especially 


56 


TREATISE  ON  EPIDEMIC  CHOLERA. 


between  rum  and  death,  which  would  abundantly 
confirm  these  statements.  The  "  Temperance  Recor- 
der" at  Albany  has  made  an  expose  on  this  subject, 
which,  however  horrible,  has  a  parallel  here,  if  the 
facts  were  obtained  by  the  same  diligent  investiga- 
tion. Of  several  hundred  cases  of  Cholera,  either 
wholly  or  partially  occurring  under  my  own  eye,  a 
very  large  and  frightful  majority,  were  either  in  in- 
temperate persons,  or  excited  by  the  use  of  spirituous 
liquors  as  a  preventive  or  cure  of  "  premonitory 
symptoms."  And  after  a  patient  investigation,  with 
the  aid  of  vigilant  friends,  of  the  mortality  in  this 
city,  I  have  been  led  to  the  conclusion,  with  at  least 
tolerable  accuracy,  that  of  the  thousands  who  died 
here  of  Cholera  within  three  short  months,  there  were 
less  than  five  hundred  who  were  not  habitually  in- 
temperate. One  of  our  benevolent  societies  relieved 
during  the  last  winter  one  hundred  and  fifty  widows, 
whose  husbands  had  all  died  of  Cholera,  and  all  of 
whom  were  drunkards.  And  in  the  case  of  intempe- 
rate persons,  the  disease  was  not  only  more  rapid  in 
its  progress,  but  almost  uniformly  fatal,  as  the  hospital 
practice  amply  proves.  Indeed,  one  of  the  physicians 
who  was  incessant  at  his  post  in  one  of  these  esta- 
blishments, told  me  that  he  had  not  known  a  single 
drunkard  cured,  by  any  treatment. 

These  facts  are  thus  presented,  as  introductory  to 
the  means  of  prevention  about  to  be  suggested,  and  on 
which  our  future  visitation,  and  the  extent  of  that 
visitation,  should  the  epidemic  again  recur,  will 
greatly  depend. 

First,  then,  I  remark,  that  as  the  remote  cause 


TREATISE  ON  EPIDEMIC  CHOLERA. 


57 


exhibited  itself  first  in  filthy  neighbourhoods,  tlie 
Corporation  should,  before  the  warm  weather  com- 
mences^ see  that  our  streets,  lanes,  alleys,  yards,  and 
houses,  are  thoroughly  cleansed  and  ventilated,  and 
that  all  our  docks,  slips,  wharves,  and  sewers,  be  care- 
fully purified,  and  kept  so  by  the  vigilant  inspection 
and  authority  of  ofl^cers  appointed  for  that  purpose. 

Secondly.  They  should  also  see  that  all  marshes, 
pools,  or  ponds  of  standing  water,  should  be  drained 
and  filled  up  earl^  in  the  Spring,  and  wherever  there 
are  filthy  stables,  whether  for  horses  or  cows,  or  pens 
in  which  swine  are  kept,  they  should  be  removed 
from  the  city,  unless  their  filthiness  can  be  pre- 
vented. 

Thirdly.  Let  our  constituted  authorities  absolutely 
prohibit  the  traffic  in  ardent  spirits,  by  wholesale  or 
retail,  in  any  population  great,  or  small,  when  the 
approach  of  the  Cholera  is  threatened.  If  this  can- 
not be  done  in  anticipation,  it  should  by  all  means  be 
enforced  on  the  first  appearance  of  the  disease  in  any 
city,  town,  or  village. 

Fourthly.  Let  all  our  prisons,  alms-houses,  or  other 
crowded  apartments,  as  those  of  the  poor  especially, 
be  daily  subjected  to  inspection,  cleansing,  and  ven- 
tilation, and  let  special  attention  be  paid  to  the  qua- 
lity of  the  meat  and  other  articles  of  provision. 

Fifthly.  Let  physicians  be  appointed  and  stationed, 
day  and  night,  in  every  neighbourhood,  on  the  first 
appearance  of  the  epidemic,  to  be  accessible  at  all 
times  by  the  poor,  for  the  treatment  of  the  premoni- 
tory symptoms,  and  let  the  plan  of  treatment  be 
agreed  on  by  the  Medical  Department  of  the  Board  of 
8 


58 


TREATISE  ON  EPIDEMIC  CHOLERA. 


Health  requiring  uniform  and  discreet  depletion,  and 
absolutely  forbidding  the  use  of  opium  or  ardent 
^piritSj  either  as  a  preventive  or  cure,  except  under 
such  restrictions  as  said  department  might  accurately 
define. 

Sixthly.  Let  clean  hospital  buildings  be  provided 
convenient  to  every  section,  to  which  those  who  by 
neglect  of  the  premonitory  symptoms,  or  by  misman- 
agement or  imprudence  of  any  kind,  shall  suffer  an 
attack,  may  be  promptly  sent,  and  let  the  plan  of 
treatment  be  defined  and  enforced ;  and  on  any  ex- 
tensive fatality  occurring  in  any  one  of  these,  let 
there  be  an  immediate  change  in  the  professional 
head  of  the  Medical  Department. 

Seventhly.  Let  measures  be  taken  to  enlighten  the 
people  generally  in  the  nature  of  the  disease,  its 
causes  and  curable  character,  and  especially  its  non- 
contagiousness,  and  this  may  be  done  by  the  circula- 
tion of  handbills  and  tracts. 

Eighthly.  Let  a  system  of  diet  and  regimen  be  pro- 
mulgated according  to  the  dictates  of  enlightened 
science,  and  let  this  system  be  recommended  through 
the  clergymen  of  every  congregation,  especially  in- 
sisting upon  total  abstinence  from  all  stimulating  or 
astringent  drinks. 

If  these,  or  equivalent  means  be  employed  in  anti- 
cipation, or  on  the  first  appearance  of  the  epidemic 
in  any  place,  its  prevalence  will  be  short,  and  the  ter- 
ror occasioned  by  its  fatality  will  be  greatly  dimi- 
nished, if  not  entirely  removed.  But  if  our  municipal 
authorities  will  neglect  their  duty,  until  the  filth  of 
our  streets,  wharves,  and  other  public  places,  become 


TREATISE  ON  EPIDEMIC  CHOLERA. 


59 


proverbial,  as  during  the  past  summer,  and  only  begin 
their  activity  and  zeal  when  the  miasma  has  been 
generated,  the  mischief  will  be  to  a  great  extent 
irreparable  ;  and  the  very  processes  of  cleansing  to 
which  they  may  afterwards  resort,  too  often  will  be 
found  only  to  aggravate  the  rage  of  the  epidemic. 
And  if  the  Corporation,  amid  the  devastations  of  ano- 
ther scourge,  should  it  again  sweep  through  our  city, 
will  continue  to  sanction  the  sale  and-use  of  spiritu- 
ous liquors  in  such  perilous  times,  as  was  done  in 
New  York  by  three  thousand  licensed  dealers;  then, 
we  may  expect  a  repetition  of  the  calamitous  results 
which  spread  such  a  gloom  over  our  city  and  country 
during  the  last  summer  :  for  experience  has  shown 
how  short  is  the  transition  from  the  grog-shop  to  the 
hospital,  to  the  grave,  and  to  perdition. 

The  facts  which  the  history  of  the  past  exhibits 
of  the  connexion  between  Cholera  and  rum,  cannot 
be  too  often  repeated,  nor  too  strenuously  urged  upon 
our  rulers  or  upon  the  public.  Thousands  are  now 
dead  of  Cholera  who  fell  by  taking  a  little  port  wine, 
"  brandy  and  water,  or  generous  wine,''  to  prevent 
their  being  sick,  and  this  too,  disgraceful  to  say  it, 
by  high  medical  authority.  In  some  instances,  this 
was  undoubtedly  the  sole  agent  which  excited  the 
disease  and  rendered  it  fatal.  In  this  city,  the  grog 
shops  were  visible  nuclei,  around  which  the  epidemic 
raged  with  unwonted  fury ;  and  death,  not  disease, 
seemed  to  reign  over  the  neighbourhoods  where  these 
haunts  of  the  destroyer  were  the  most  numerous. 
Many  of  the  keepers  of  these  abominable  styes  of 
pollution,  and  some  of  their  families,  were  swept 


60 


TREATISE  ON  EPIDEMIC  CHOLERA. 


away ;  and  horrible  to  relate,  other  lovers  of  rum  and 
its  "  wages,"  would  re-open  the  shops  thus  vacated  by 
the  pestilence,  and  deal  out  Cholera  and  death,  un- 
til they  too  became  the  victims  of  their  temerity.  In 
many  instances,  after  burying  one  or  more  of  their 
families,  the  keepers  of  these  grog  shops  would  be- 
come alarmed,  close  their  doors,  and  fly  from  the  city. 
But  some  of  them  were  so  covetous  of  the  "  wages  of 
unrighteousness,"  that  they  would  return  in  time  to 
re-open  their  doors  on  Saturday  nights,  continue  in  the 
midst  of  their  victims  until  Monday  morning,  when 
they  would  again  leave  the  scene  of  danger,  thus  se- 
curing their  Sabbath  custom.  Hence,  as  was  fre- 
quently remarked,  the  reports  were  so  fearfully  aug- 
mented on  each  successive  Monday  and  Tuesday,  and 
universal  panic  pervaded  all  classes  of  our  citizens, 
except  the  Honourable  Corporation,  who  seemed  to 
share  but  little  in  the  consternation,  and  profit  less  by 
the  lesson  we  were  thus  so  dearly  taught.  For,  by 
their  authority  and  license,  these  deeds  of  infamy 
were  perpetuated  until  the  cold  weather  of  the  au- 
tumn arrested  the  epidemic,  after  thousands  had  fal- 
len martyrs  to  the  licensed  and  unlicensed  dealers 
in  rum. 

I  forbear  to  pursue  this  subject  farther,  for  the 
heart  sickens  at  the  bare  recital  of  these  shocking 
scenes,  which  might  have  been  arrested,  to  a  great 
extent  at  least,  by  the  Corporation,  had  they  yielded 
to  the  conviction  which  death  made  so  apparent,  and 
suppressed  the  sale  of  ardent  spirits  during  the  epi- 
demic by  rigid  enactments,  as  was  done  at  Wash- 
ington, D.  C.  with  complete  success.  Instead  of  which, 


TREATISE  ON  EPIDEMIC  CHOLERA. 


61 


they  prohibited  the  sale  of  fruits  and  garden  vegeta- 
bles, which,  compared  with  rum,  were  innocent; 
thus  "straining  at  a  gnat,  and  swallowing  a  camel." 

With  regard  to  disinfecting  remedies,  they  must 
be  regarded  as  at  best  equivocal  in  their  character 
and  in  their  effects.  The  burning  of  tar,  brimstone, 
and  other  combustible  substances,  produce  no  other 
good  effect  than  the  kindling  of  large  fires  with  any 
other  material ;  and  their  offensive  odour  is  not  there- 
fore compensated  for  by  any  specific  virtues.  The 
Chlorides  of  Lime,  Soda,  (fee,  are  undoubtedly  useful 
in  attracting  putrid  and  unpleasant  odours  of  what- 
ever kind  to  themselves;  and  yet  the  Chlorine,  when 
used  to  the  extent  it  was  in  some  places,  was  quite 
as  offensive  to  the  olfactories,  and  even  as  unhealthy, 
when  inspired  into  the  lungs,  as  any  of  those  for 
which  it  is  prescribed  as  an  antidote.  These  disin- 
fecting agents  are,  therefore,  of  much  less  importance, 
and  much  less  to  be  depended  on,  than  people  have 
been  led  to  believe.  To  sprinkle  Chloride  of  Lime 
freely  into  the  gutters,  privies,  stables,  and  other 
filthy  places  in  the  city,  may  be  a  judicious  expendi- 
ture on  the  part  of  the  Corporation:  and  for  the  filthy 
apartments  of  houses  where  the  disease,  or  death,  has 
left  an  offensive  stench,  the  Chloride  of  Soda  in  solu- 
tion will  be  an  appropriate  antiseptic,  to  be  sprinkled 
on  the  floors,  or  placed  in  a  vessel  on  the  floor.  If 
either,  however,  be  carried  to  excess,  as  is  too  often 
done,  they  cease  to  be  useful,  and  are  often  directly 
mischievous. 

On  the  subject  of  personal  and  individual  means  of 
prevention.  I  shall  content  myself  with  very  brief 


62 


TREATISE  ON  EPIDEMIC  CHOLERA. 


remarks,  having  partly  anticipated  this  department 
of  prevention  in  a  former  chapter. 

A  state  of  predisposition,  or  an  epidemic  constitu- 
tion, as  it  has  been  called,  is  already  superindu- 
ced, when  the  disease  begins  to  prevail,  in  every 
man,  woman,  and  child,  who  has  been  living  but  a 
few  days  and  nights  in  the  atmosphere  of  the  infect- 
ed city  or  neighbourhood.  It  is  altogether  absurd, 
therefore,  to  talk  of  prevetiting  our  being  predispo- 
sed, or  of  escaping  by  leaving  the  neighbourhood, 
after  being  impressed  with  the  remote  cause.  The 
true  means  of  prevention,  and  those  which  would  be 
almost  universally  successful,  are  the  avoidance  of 
the  exciting  causes,  and  thus  rendering  the  state  of 
predisposition  one  of  perfect  and  entire  immunity 
from  the  disease.  All  preventives  recommended  on 
any  other  principle  proceed  from  ignorance  or  impos- 
ture, most  generally  from  the  latter  ;  and  all  such  re- 
medies, therefore,  which  profess  to  prevent  an  attack 
by  being  taken  before  the  individual  is  sick,  are  but 
the  stupid  prescriptions  of  mountebanks  and  quacks, 
not  excepting  the  use  of  "  brandy  and  water,  or  ge- 
nerous wine,"  which  are  the  best  entitled  to  the 
epithet  of  quackery,  of  any  in  the  whole  catalogue  of 
the  nostrums  for  prevention. 

First,  then,  let  all  indigestible  food,  of  whatever 
kind,  be  avoided  by  those  who  are,  or  have  been,  ex- 
posed to  the  remote  cause,  and  let  there  be  no  exces- 
sive indulgence  in  the  morbid  appetite  by  which  an 
epidemic  constitution  is  often  characterized.  The 
living  should  be  plain,  simple,  and  more  sparing 
than  usual,  for  the  simple  reason  that  most  persons 


TREATISE  ON  EPIDEMIC  CHOLERA.  63 

in  health  eat  twice  as  much  at  their  meals  as  is  ei- 
ther necessary  or  useful.  To  deny  ourselves  all  ve- 
getables and  fruit  from  a  superstitious  fear,  and,  at 
the  same  time,  load  the  stomach  with  an  increased  al- 
lowance of  flesh,  fish,  and  fowl,  is  the  very  climax  of 
absurdity.  Such  preventive  management  has  often 
excited  the  disease. 

Second.  Adopt  the  maxims  of  enlightened  science^ 
on  the  subject  of  ardent  spirits,  wine,  beer,  cider,  and 
all  other  intoxicating  drinks,  and  practise  total  absti- 
nence from  these  and  all  other  articles  which  stimu- 
late the  body  beyond  the  healthy  standard.  This  is 
the  most  important  in  the  scale  of  preventive  mea- 
sures, and  should  be  universally  adopted,  without  re- 
gard to  previous  habits  and  modes  of  living.  If  per- 
sons have  continued  in  the  daily  use  of  spirituous  li- 
quors or  wine  for  years  without  having  sensibly  suf- 
fered in  their  health ;  yet  now  that  they  are  impressed 
with  the  remote  cause  of  Cholera,  and  have  imbibed 
a  predisposition,  there  is,  there  can  be,  no  security, 
but  in  abandoning  their  habit  at  once.  The  cautions 
that  have  been  given  about  the  danger  of  changing 
the  customs  of  living,  and  insisting  upon  a  continu- 
ance in  the  usual  allowance  of  ardent  spirits,  are  but 
another  of  the  changes  which  have  been  rung  by  the 
apologists  for  rum,  and  the  publication  of  these 
directions  multiplied  the  victims  of  the  pestilence 
wherever  they  have  been  followed.  If  there  be  any 
one  fact  unequivocally  taught  by  the  experience  of  the 
last  year,  it  is  this;  that  rum,  in  any  one  of  its  formSy 
is  not  only  a  frequent  exciting  cause  of  Cholera,  but 
the  most  frequent  of  all  its  causes;  and  hence  it  is 


64 


TREATISE  ON  EPIDEMIC  CHOLERA. 


as  true  here  as  it  has  been  proven  to  be  in  Albany, 
that  among  those  who  suffered  an  attack  from  other 
exciting  causes,  but  few  died;  and  among  tliose  in 
whom  the  disease  was  excited  by  ardent  spirits, 
but  few  recovered.  In  Albany,  it  was  accurately 
ascertained,  and  has  been  published  by  her  inde- 
fatigable State  Temperance  Society,  that  but  two 
cases  occurred  among  the  thousands  of  citizens 
who  adhered  to  their  pledge  of  total  abstinence  as 
members  of  their  Society.  This  fact  should  be  every 
where  known,  and  every  where  appreciated,  that 
the  mischievous  and  fatal  use  of  spirituous  liquors, 
either  as  a  preventive  or  cure,  may  never  again  so 
fearfully  multiply  the  victims  of  the  pestilence  in 
any  place,  or  among  any  people. 

Third.  Next  to  moderation  in  eating,  and  total  ab- 
stinence from  ardent  spirits  and  other  stimulating 
articles,  strict  attention  should  be  paid  to  the  condi- 
tion of  the  skin,  Avhich,  in  such  perilous  times,  ought 
not  to  be  overlooked.  Flannel  next  the  body  should 
be  worn  universally,  and  on  a  sense  of  chilliness  oc- 
curring, the  individual  should  bathe  the  feet  in  warm 
water  before  going  to  bed,  and  adopt  some  domestic 
expedient  for  inducing  a  gentle  perspiration.  Expo- 
sure to  damp  and  wet  weather  was  frequently  fol- 
lowed by  an  attack. 

Lastly.  The  mind  should  be  preserved  in  a  state 
of  calmness  and  composure,  and  all  undue  excite- 
ment or  depression  be  scrupulously  avoided.  Al- 
though the  depressing  tendency  of  fear  has  often  ex- 
cited the  disease,  yet  the  exciting  passions,  indulged 
to  excess,  as  anger,  (fcc.  have  also  been  productive  of 


TREATISE  ON  EPIDEMIC  CHOLERA. 


65 


the  same  result.  Instances  of  this  unhappy  result 
from  both  of  these  causes,  must  have  occurred  under 
the  observation  of  every  extensive  practitioner  in 
this  as  well  as  other  epidemic  diseases. 

It  will  thus  be  seen  that,  among  the  means  of  pre- 
vention to  be  used  by  individuals,  I  have  recommend- 
ed no  medicines.  Although  thousands  of  nostrums 
have  been  recommended  by  as  many  quacks,  and  some 
of  them,  with  their  mountebank  authors,  have  been 
puffed  by  certificates  of  members  of  my  own  profes- 
sion, who  have  thus  degraded  their  names,  and  still 
more,  the  professional  titles  affixed  to  them,  yet  I  must 
pronounce  all  these  nostrums,  by  whomsoever  com- 
mended or  sold,  to  be  a  base  and  unprincipled  imposi- 
tion upon  public  credulity  ;  and  many  of  them  the  re- 
sult of  an  atrocious  conspiracy  against  the  property, 
health,  morals,  and  lives  of  the  community.  With  a 
knowledge  of  the  direful  eff"ects  of  such  imposture, 
in  exciting  the  disease  and  rendering  it  fatal  during 
the  last  year  ;  and  with  a  knowledge  of  preconcerted 
plans  which  have  been  devised  to  gull  the  vulgar 
and  rob  the  ignorant,  even  in  anticipation  of  the  recur- 
rence of  the  epidemic — I  should  be  recreant  to  my  duty 
as  one  of  the  guardians  of  the  public  health,  if  I  did 
not  utter  this  rebuke,  and  off'er  this  warning,  against 
so  criminal  and  so  mischievous  an  imposition.  The 
pecuniary  success  which  some  of  these  boasted  pre- 
ventives received,  during  the  last  year,  will  doubtless 
embolden  empiricism,  should  the  Cholera  unhappily 
revisit  us ;  and  if  our  population  should  generally  be 
so  gulled  as  to  take  these  nostrums  as  preventives, 
even  though  they  be  only  ''brandy  or  wine,"  we 
9 


66  TREATISE  ON  EPIDEMIC  CHOLERA. 

shall  suffer  results  quite  as  calamitous  as  those  which 
the  epidemic  itself  will  inflict,  and  its  mischiefs  he 
incalculably  augmented. 

I  have  thus  finished  my  hrief  observations  on  the 
nature,  causes,  treatment,  and  prevention  of  Cholera, 
with  as  much  perspicuity  as  the  subject  will  ad- 
mit; and  with  the  hope  that  their  publication  may 
be  useful,  especially  in  those  places  where  it  may 
occur  hereafter,  I  now  submit  the  whole  to  my 
fellow-citizens,  with  the  ardent  wish  that  they 
may  never  witness  a  recurrence  of  the  scenes  of  the 
last  year  to  the  same  extent,  if,  indeed,  they  shall 
suffer  another  visitation  of  this  cruel  epidemic. 

From  the  expression  of  my  own  views,  it  will  be  , 
seen  that  I  regard  a  recurrence  of  the  disease  as  fully 
capable  of  prevention,  if  proper  means  be  adopted ; 
and,  even  should  it  revisit  us,  that  our  Corporation  may 
diminish  its  mischiefs,  and  lighten  the  calamity,  by  a 
suitable  exercise  of  their  authority.  In  the  confident 
expectation  that  judicious  means  of  prevention  will 
be  used,  and  the  necessary  authority  exercised,  for  a 
time  at  least,  I  entertain  but  little  apprehension  that 
this  city  will  be  the  scene  of  its  visitation  the  present 
year.  There  may,  and  probably  will  be,  sporadic  or 
Individual  cases;  but  reasoning  from  analogy,  it  is 
not  at  all  probable  that  Cholera,  as  an  epidemic, 
will  prevail  extensively  very  soon  in  the  same  places 
which  so  severely  suffered  the  last  year,  especially  in 
the  North  and  East,  where  our  climate  favours  our 
success  in  its  prevention.  In  the  South,  as  in  New 
Orleans,  and  on  the  rivers  of  the  West,  where  large 
districts  of  malarious  country  are  thickly  populated, 


TREATISE  ON  EPIDEMIC  CHOLERA. 


67 


there  is  much  greater  cause  of  apprehension.  And 
it  is  very  probable  that  in  those  places  where  the 
Yellow  Fever  has  annually  been  epidemic,  the  Cho- 
lera may  take  its  place;  if,  as  I  have  contended,  both 
arise  from  causes  so  similar  in  their  nature,  and  dif- 
fering only  in  the  degree  of  intensity.  Should  this 
be  the  fact,  however,  I  feel  assured,  that  when  en- 
lightened views  of  the  disease  shall  universally  pre- 
vail. Cholera  will  be  found  to  be  much  more  suscep- 
tible of  cure  than  the  malignant  or  Yellow  Fever, 
by  which  fatality  our  southern  countrymen  have 
so  severely  suffered.  If  the  Cholera  be  successful  in 
its  progress  through  our  country,  in  awakening  the 
national,  and  state,  and  city  governments,  to  the  ne- 
cessity of  banishing  all  intoxicating  liquors  from  the 
land,  though  its  track  has  been  one  of  devastation 
and  death ;  yet,  by  this  "  consummation  so  devoutly 
to  be  wished,"  there  would  be  more  lives  preserved 
from  the  drunkard's  grave  in  a  single  year,  than  the 
Cholera  would  be  able  to  kill,  without  rum,  its 
most  mighty  auxiliary,  in  half  a  century.  Indeed, 
statistical  calculations  of  the  comparative  morta- 
lity during  the  last  calamitous  year,  would  satis- 
factorily demonstrate,  if  they  could  be  accurately 
made,  that  in  this  country  at  least,  where  Cholera 
has  slain  its  thousands.  Rum  has  slain  its  tens  of 
thousands,  apart  from  the  vast  proportion  in  which 
both  these  ''destroying  angels"  have  united  their 
deadly  influence. 

But  to  prevent  the  recurrence  of  this  disease,  I 
again  reiterate  the  sentiment,  that  the  public  ought 
not  to  be  misled  by  a  reliance  being  placed  upon 


68 


TREATISE  ON  EPIDEMIC  CHOLERA. 


quarantine  or  other  regulations,  designed  to  obstruct 
its  importation  ;  nor  should  they  consent  to  withhold 
the  expression  of  their  merited  censure  upon  our  con- 
stituted authorities,  by  the  contemptible  pretence 
set  up,  after  it  has  appeared,  that  it  has  been  brought 
by  importation,  and  transmitted  by  contagion. 

Even  now,  while  the  present  work  is  passing 
through  the  press,  there  is  more  than  one  city  in  the 
United  States,  whose  Health  Department  is  making 
little  other  preparation  by  way  of  prevention,  than 
guarding  against  the  arrival  of  vessels  from  suspect- 
ed places,  or  such  as  have  cases  of  disease  on  board, 
supposed  to  be  Cholera  ;  and  are  quieting  the  ap- 
prehensions of  the  public  by  passing  ordinances 
inflicting  heavy  penalties  against  a  violation  of 
quarantine. 

Let  the  public  demand  of  their  representatives  in 
the  city  governments,  that  the  necessary  work  of 
cleansing  the  city  should  be  diligently  performed,  not 
merely  that  officers  should  be  appointed  to  do  it,  and 
paid  with  the  public  money  ;  but  that  they  see  that 
it  is  done.  And  I  again  repeat,  that  if  it  be  neglect- 
ed until  the  hot  weather  gives  origin  and  being  to 
the  mischief,  the  public  ought  not  to  be  satisfied 
with  the  show  of  great  diligence  after  the  disease 
appears,  for  the  mischief  is  not  only  then  irrepara- 
ble, but  the  very  attempts  at  purification  will  often 
only  increase,  if  it  does  not  originate,  the  mischief 
they  are  designed  to  remove. 


APPENDIX. 


A 

BRIEF  ESSAY 

ON  THE 

MEDICAL  USE  OF  ARDENT  SPIRITS ; 

BEING 

AN  ATTEMPT  TO  SHOW  THAT  ALCOHOL  IS  AS  UNNECESSARY 
AND  MISCHIEVOUS  IN  SICKNESS  AS  IN  HEALTH. 


AFFECTIONATELY  INSCRIBED  TO  THE  AMERICAN  TEMPERANCE  SOCIETY. 


BY  DAVID  MEREDITH  REESE,  M.  D. 

OF  NEW  YORK. 


APPENDIX. 


So  closely  have  the  names  of  Cholera  and  Rum 
been  united,  in  almost  every  country,  since  its  epide- 
mic history  has  been  attracting  public  attention,  that 
I  have  deemed  this  Appendix  a  suitable  one  to  accom- 
pany the  observations  I  have  made  upon  our  late 
epidemic.  And  I  propose  at  present  only  a  brief  ap- 
peal to  my  professional  brethren  and  the  public,  re- 
serving to  myself,  as  an  ample  subject  for  another 
volume,  should  life  and  health  permit,  the  history, 
chemical  nature,  physiological,  and  pathological 
effects  of  spirituous  liquors  on  the  human  body,  as 
exhibited  in  the  living  and  the  dead. 

For  my  present  purpose  it  will  be  sufRcient  to  re- 
mark, that  alcohol  was  introduced  into  public  fa- 
vour at  first  by  its  medical  use.  and  this  was  not  only 
its  first  entering  wedge,  but  it  will  be  its  last  strong- 
hold ;  and  while  intrenched  here  it,  will  be  utterly 
impregnable.  It  is  said,  with  great  plausibility,  that 
it  was  first  given  in  draclLin  doses,  as  a  medicine,  and 
therefore,  though  the  dose  has  been  increased  both  in 
quantity  and  in  the  frequency  of  its  repetition,  yet 
these  doses  are  still  called  drams  to  this  day.  Be  this 


72 


APPENDIX. 


as  it  may,  however,  there  can  he  no  doubt,  that  this 
powerful  agent  was  once  used  only  medicinally,  and 
that  in  extreme  cases ;  and  yet  the  facilities  of  mo- 
dern improvement  in  distillation  has  made  it  so  cheap 
and  abundant,  that  until  within  a  few  years  it  was, 
throughout  this  and  other  countries,  scarcely  ever 
used  as  a  medicine ;  hut  had  become  a  common  arti- 
cle of  drink  and  of  commerce,  and  was  deemed  one 
of  the  "  necessaries  of  life}^  So  habitual  and  universal 
was  the  practice  of  daily  using  ardent  spirits  in 
some  form,  that  scarcely  a  family  were  content  to 
live  without  it,  and  scarcely  an  individual  could 
dispense  with  it,  especially  if  called  on  to  make  any 
considerable  effort,  either  physically  or  mentally. 

Meanwhile,  there  were  among  the  wise  and  good, 
some  who  escaped  this  whirlpool  of  fashion,  and 
who  mourned  over  the  wide-spreading  desolations  of 
intemperance,  but  without  perceiving  any  hope  for 
those  who  were  swallowed  up  in  its  vortex,  and  in- 
deed unable  to  discover  any  way  of  escape  for  the 
multitudes  of  their  fellow-citizens,  who  were  slum- 
bering unconsciously  on  the  verge  of  a  gulph,  more 
horrible  than  the  yawning  mouth  of  any  burning 
crater  which  ever  smoked  upon  the  summit  of  ^tna 
or  Vesuvius.  The  dreadful  statistics  of  pauperism 
and  crime,  disease  and  death,  which  they  now  dis- 
covered, were  obviously  the  result  of  the  vice  of  in- 
temperance, (and  which  they  began  to  collect,  re- 
cord, and  contemplate,)  disclosed  a  dark  and  melan- 
choly picture  of  human  wretchedness,  which,  as  pa- 
triots and  as  Christians,  they  resolved  to  expose  to 
public  view,  and  call  upon  their  fellow-citizens  to 


APPENDIX. 


i 

73 


unite  in  an  attempt  to  relieve,  by  removing  the  cause 
of  these  accumulated  mischiefs. 

After  much  reflection,  many  experiments,  and  a  full 
interchange  of  opinion  among  the  benevolent  projec- 
tors of  this  scheme  of  philanthropy,  and  with  a  con- 
fident reliance  on  that  God  in  whose  name  they 
trusted,  and  whose  smiles  and  benediction  they  de- 
voutly implored,  they  resolved  to  begin  this  great 
and  good  work,  by  imposing  upon  themselves  indivi- 
dually a  vow  of  total  abstinence  from  the  use  of 
ardent  spirits,  and  by  calling  upon  their  fellow-coun- 
trymen to  unite  with  them  in  this  vow. 

Thus,  by  a  small  number  of  friends  of  their  country, 
and  friends  of  man,  the  "  American  Temperance  So- 
ciety  "  began  its  operations,  and  what  is  now  digni- 
fied by  the  appropriate  title  of  the  Temperance  Re- 
formation, has  been  the  happy  and  stupendous  result. 
Already  this  cause  has  gained  upon  public  estimation 
in  this  and  in  foreign  lands,  until  millions  of  our  fellow- 
men  have  joined  their  names  and  example  to  the 
holy  enterprise,  and  hundreds  of  thousands  have  been 
rescued  from  the  daily  use  of  spirituous  liquors,  which 
might  have  proved  their  ruin,  but  for  the  timely  influ- 
ence of  this  Temperance  efl'ort.  Such  have  been  the  vic- 
tories over  opinion,  and  custom,  and  prejudice,  which 
this  cause  has  achieved,  that  not  only  the  use,  but  the 
traffic  in  ardent  spirits,  has  sensibly  diminished,  and 
the  ultimate  banishment  of  the  article  from  the  na- 
tion, and  from  the  world,  begins  to  appear  practicable 
in  a  short  period,  if  the  success  of  the  enterprise  be 
not  prevented  by  some  new  counter-revolution. 

In  this  state  of  acceleration  gained  by  the  friends 
10 


74 


APPENDIX. 


of  temperance  for  their  scheme  of  benevolence,  there 
is  one  only  obstacle  in  the  way  of  the  ultimate,  com- 
plete, and  universal  victory  of  the  cause,  and  but  for 
this  both  the  traffic  and  consumption  of  alcohol 
could  be  exterminated  from  the  land  almost  at  a 
blow.  That  obstacle  is  its  medical  use;^^  and  this 
is  the  last  strong-hold  of  intemperance,  into  which 
the  monster  rum  has  been  driven,  and  where  he  finds 
a  safe  refuge,  whence  he  slays  his  tens  of  thousands. 
And,  to  speak  without  a  metaphor,  if  this  medical 
use  of  spirituous  liquors  is  either  defensible  or  allow- 
able, the  progress  of  reform  on  this  subject  is  nearly 
at  an  end. 

I  believe  that  the  opinion,  that  ardent  spirits  is 
either  necessary  or  useful  for  any  man  while  in 
health,  is  now  nearly  abandoned.  Certainly  no  man 
having  pretensions  to  character  in  our  profession, 
would  hazard  his  reputation  by  affirming  it,  in  the 
face  of  the  most  enlightened  and  scientific  opinions 
which  have  been  elicited  from  so  many  distinguish- 
ed sources ;  and  especially  when  millions  of  our  fel- 
low men  are  demonstrating,  by  their  high  health,  in 
every  department  of  life,  that  they  can,  and  do,  to- 
tally abstain  from  spirituous  liquors,  not  only  with- 
out detriment,  but  with  manifest  and  sensible  advan- 
tage. This  point  is  therefore  amply  established,  that 
ardent  spirits  are  never  necessary  or  useful  in  health; 
and,  therefore,  no  man  can  rationally  object  to  the 
principles  of  the  Temperance  reformation  on  this 
account,  at  this  day,  whatever  might  have  been 
said,  and  was  said,  before  this  question  was  settled, 
as  it  now  is,  and  for  ever. 


APPENDIX.  75 

This  has  often  been  affirmed  hy  individuals  before, 
but  the  whole  weight  of  public  opinion  was  against 
them,  and  hence  but  little  impression  was  made  upon 
the  public  practice.  That  learned  and  venerable 
man,  John  Wesley,  nearly  a  century  ago,  declared 
that  "  ardent  spirits  was  never  necessary  in  health, 
and  seldom  would  be  in  sickness^  but  for  the  awk- 
wardness and  unskilfulness  of  the  practitioner." 
And  although  the  former  part  of  this  sentiment  is 
now  demonstrated  to  be  correct,  yet  the  latter  is  still 
called  in  question,  though  it  is  equally  well-founded, 
as  I  shall  presently  attempt  to  show. 

In  attacking  this  dernier  subterfuge  of  ardent  spi- 
rits, I  am  aware  that  I  am  liable  to  be  ranked  among 
those  ultras  in  physics  and  in  morals,  who  are  ordi- 
narily denounced  as  enthusiasts,  fanatics,  visionaries, 
and  the  like  ;  and  thus,  too  often,  by  an  opprobrious 
epithet,  the  advocates  of  truth  are  confounded  in 
their  honest  and  well-meant  endeavours,  by  censori- 
ousness  rather  than  by  argument.  Indeed,  I  shall  have 
arrayed  against  me,  not  merely  all  the  male  and  fe- 
male quacks  in  the  land,  with  their  boasted  experi- 
ence and  alcoholic  nostrums ;  but  I  must  contend 
with  the  sages  and  philosophers  of  medical  science, 
many  of  whom  have  written  largely  on  the  wonder- 
ful and  sovereign  efficacy  of  Brandy  and  Gin,  as  spe- 
cifics in  various  diseases.  Besides  all  this,  there  are 
in  all  the  standard  text  books,  pharmacopoeias,  and 
dispensatories,  thousands  of  valuable  medicines  pre- 
pared in  alcohol,  and  thousands  more  of  worthless 
medicines,  which  owe  all  their  boasted  virtues  to 
their  alcoholic  menstrua.    And  add  to  all  these,  the 


76 


APPENDIX. 


fact,  that  a  great  proportion  of  our  regularly  educa- 
ted physicians  have  each  a  score  of  recipes  or  pre- 
scriptions, which,  from  time  immemorial,  have  heen 
given  in  gin,  or  spirits,  or  rum ;  and  v^hich  they  find 
both  popular  and  profitable  And  when  it  is  recol- 
lected, in  addition,  that  the  experience  of  almost 
every  family  furnishes  instances  of  relief  in  certain 
complaints  by  some  form  of  alcoholic  medicine,  it 
will  be  seen  that  the  array  in  behalf  of  the  medical 
use  of  ardent  spirits  is  a  formidable  one  indeed. 

But  none  of  these  things  move  me  from  the  pur- 
pose I  have  distinctly  avowed  ;  to  assail  the  medi- 
cal use  of  ardent  spirits,"  as  not  merely  unnecessary 
and  injurious,  but  as  the  most  powerful  and  mis- 
chievous source  of  intemperance,  with  which  the 
nation  is  now  afflicted,  and  the  only  considerable 
obstruction  to  the  benevolent  designs  of  the  Tempe- 
rance reformation. 

The  present  fashionable  use  of  ardent  spirits  as  a 
medicine  begins  at  birth,  and  is  only  relinquished 
when  the  individual  is  dead.  No  sooner  is  a  child  born 
into  the  world,  than  it  must  be  intoxicated  by  the  fumes 
of  spirits,  externally  applied  to  the  whole  surface  of 
the  body,  by  some  superannuated  nurse,  who  has  been 
taught  to  do  so  from  time  immemorial.  This  practice, 
although  so  universal,  is  a  vile  and  mischievous  one; 
and  I  never  knew  any  motive  for  its  continuance  but 
the  opportunity  it  affords  the  nurse  to  swallow  a  lit- 
tle during  the  operation.  I  never  allow  it  in  my 
presence,  but  direct  cold  water  in  its  stead  ;  and  1 
believe  many  infantile  diseases,  in  delicate  children, 
result  from  this  washing  in  rum. 


APPENDIX. 


77 


If  the  child  is  not  stupified  by  this  outward  opera- 
tion, and  continues  to  cry  until  it  is  troublesome, 
there  are  mothers,  grandmothers,  nurses,  and  often 
doctors,  I  am  ashamed  to  say  it,  who  will  order  herb 
tea  with  a  little  gin  in  it  to  make  it  sleep;  and 
this  convenient  quietus  of  gin  is  repeated  when  sleep 
is  desirable  by  the  indolence  of  the  nurse,  every  day 
and  night,  until  the  dose  requisite  for  the  purpose  is 
so  large  that  it  is  difficult  to  give  so  much,  or  the  in- 
fant's stomach  rejects  it;  and  then  comes  the  far- 
famed  Godfrey's  Cordial,  Paregoric,  or  some  other 
sleeping  draught  made  of  rum  and  opium,  or  some 
other  intoxicating  ingredient.  Thus  in  earliest  in- 
fancy does  the  medical  use  of  ardent  spirits  often 
inflict  injury  which  sends  the  child  to  a  premature 
grave,  or  inflicts  upon  it  a  feeble  constitution  for  life. 
Now,  all  this  use  of  alcohol  as  a  medicine,  is  under- 
stood by  every  man  of  sense  in  the  profession  to  be 
not  only  useless,  but  hurtful ;  and  yet  it  is  still  suff"ered, 
because,  to  oppose  it,  is  to  encounter  the  prejudice  of 
every  old  lady  in  the  land. 

This,  then,  is  one  argument  by  which  the  neces- 
sity of  keeping  alcohol  in  the  house,  as  a  medicine, 
is  insisted  on ;  and  it  is  as  unanswerable  as  any 
other  which  the  advocates  or  apologists  for  rum  in 
medicine  can  furnish.  And  I  affirm,  in  its  refutation, 
that,  for  the  purpose  of  washing  a  new-born  infant, 
cold  water  in  summer,  and  tepid  water  and  soap  in 
winter,  is  the  only  proper  material ;  and  that,  to  make 
it  sleep,  or  for  any  other  of  the  purposes  for  which 
gin  and  the  like  is  given,  the  mother's  milk,  and  this 
alone,  should  be  introduced  into  the  stomach;  or,  where 


78 


APPENDIX. 


this  Is  unavoidably  absent,  sweetened  milk  and  wa- 
ter. There  are  more  children  killed  in  infancy  by 
gin  and  alcoholic  medicines,  than  die  from  all  our  in- 
fantile diseases  beside. 

But  I  cannot  pursue  this  subject  farther,  and  will 
pass  on  to  remark,  that  another  mischievous  medical 
use  of  alcohol  is  the  practice  of  bribing  children  as 
they  grow  up  to  take  medicine  in  sugar-dram.  When 
they  become  sick,  and  medicine  is  required,  they  are 
often  induced  to  take  it  by  mixing  it  in  toddy,  and 
then  drinking  a  glass  of  the  same  to  wash  it  down. 
The  evil  is  not  merely  the  counteracting  effect  of  the 
alcohol,  but  that  the  child  is  taught  that  it  is  not  only 
right,  but  desirable;  and  an  artificial  appetite  for  it  is 
thus  created,  which  increases,  until  it  often  results  in 
the  destruction  of  health  and  life. 

In  many  families,  it  is  common  to  have  a  bitters, 
as  it  is  called,  made  of  garlic,  or  herbs  of  some  kind, 
good  for  worms,  colic,  or  some  other  of  the  name- 
less diseases  of  which  children  are  often  only  sup- 
posed to  suffer;  and  these  bitters  are  frequently  drank 
by  all  in  the  house,  parents,  children,  and  domestics. 
These  bitters  are,  for  the  most  part,  prepared  with  alco- 
hol for  a  menstruum,  and  have  made  more  drunkards 
in  this  country  than  perhaps  all  other  causes  combined. 
Witness  the  famous  bitters  of  Dr.  Thomson,  of  Albany, 
who  boasts  of  having  sold  30  barrels  in  a  single  year. 
These  are  made  of  Malaga  wine,  and  are  drank  and 
recommended  for  the  sake  of  the  alcohol  that  is  in 
them,  by  the  lovers  of  rum  as  a  medicine.  See  also 
Dr.  Solomon's  Balm  of  Gilead,  by  which  he  made  a 
princely  fortune,  and  Dr.  Dyott's  Cordial,  which  has 


APPENDIX. 


79 


been  little  less  successful.  These,  with  all  the  tribe 
of  stomachic  bitters,  cordials,  elixirs,  and  medica- 
mentums,  are  but  devices  founded  upon  the  medical 
use  of  ardent  spirits,  and  for  the  most  part  possess 
no  active  properties  other  than  the  alcohol  imparts. 
So  manifest  had  the  ruinous  effects  of  all  this  class 
of  medicines  become,  as  early  as  the  days  of  the  ve- 
nerable Rush,  that  he  banished  them  from  his  mate- 
ria medica,  and  taught  his  students  in  the  University 
of  Pennsylvania,  from  his  professorial  chair,  that  all 
such  medicines  were  pernicious  to  the  health,  as  well 
as  destructive  to  the  morals  of  the  community.  And 
when  his  patients  would  ask  permission  to  take  his 
prescriptions  in  gin,  or  spirituous  liquors  of  any  kind, 
he  would  reply,  "  No  man  shall  look  me  in  the  face 
in  the  day  of  judgment,  and  say  Dr.  Rush  made  me 
a  drunkard."  And  he  would  often  add,  "  If  God  will 
forgive  me  for  making  drunkards  in  the  early  part 
of  my  practice,  when  I  knew  no  better,  I  will  never 
make  another."  If  his  mantle  had  fallen  upon  his 
successors,  happy  would  it  have  been  for  the  nation 
and  for  the  world. 

But,  alas !  in  the  face  of  the  ten  thousand  facts 
which  this  subject  has  presented,  no  prescription  has 
been  and  is  more  common  with  very  many  physi- 
cians than  a  mixture  of  tonic  bitters,  to  be  mingled 
with  gin,  or  some  other  form  of  intoxicating  liquor. 
No  marvel  that  dyspeptics  should  multiply  on  every 
hand,  when  such  practice  is  pursued  with  almost 
every  derangement  of  the  digestive  organs ;  nor  is  it 
any  wonder  that  drunkenness  should  become  so  wide- 
spread an  evil,  when  a  large  proportion  of  our  adult 


80 


APPENDIX. 


population  are  regularly  dosed  with  alcoholic  medi- 
cines. 

Thus  far  I  have  not  spoken  of  the  stupidity  of 
those  who  daily  use  brandy,  gin,  or  any  other  form 
of  spirits,  with  or  without  water,  from  any  medical 
quality  which  these  stimuli  are  supposed  to  possess. 
For,  although  they  find  that  these  liquors,  taken 
alone,  produce  the  same  sensations  of  relief  which 
they  felt  while  using  the  medical  bitters  compounded 
with  them,  and  have  been  thus  taught  to  drink  by 
using  alcoholic  medicines,  yet  these  sensations  are 
deceptive,  and  destructive  to  the  stomach.  Alcohol 
possesses  no  medical  virtue  whatever,  which  does  or 
can  compensate  for  the  injury  it  does  to  the  human 
system,  if  taken  in  repeated  doses,  or  if  those  doses 
be  larger  than  can  be  given  by  drops.  It  is  on  this 
principle,  only,  that  the  very  large  class  of  tinctures 
can  be  innocently  retained  in  the  materia  medica. 
All  these  are  alcoholic,  but,  like  laudanum,  are  given 
in  small  doses  of  10  or  20  drops,  and  this  small  quan- 
tity of  alcohol  produces  no  sensible  effect.  But  all 
those  tinctures,  elixirs,  essences,  cordials,  or  bitters, 
which  require  to  be  given  in  larger  doses  than  a  tea- 
spoonful,  ought  to  be  rejected  from  practice.  And 
that  they  can  be  rejected  without  either  injury  or  in- 
convenience, is  shown  by  the  fact  that  Dr.  Rush  laid 
them  all  aside  for  many  years  before  his  death,  and 
that  very  many  physicians  of  extensive  practice 
in  this  country  never  use  them  under  any  circum- 
stances. 

The  project,  therefore,  deemed  by  some  as  an  Uto- 
pian one,  of  excluding  alcohol  entirely  from  the  ma- 


APPENDIX. 


81 


teria  medica,  is  perfectly  feasible,  for  every  physician 
knows  how  to  prepare  the  article  used  in  the  form  of 
tincture  in  some  other  form ;  and  I  again  repeat,  that 
the  alcohol,  in  all  these,  possesses  no  medical  quality 
or  virtue  whatever. 

To  show,  in  a  striking  light,  how  one  of  the  sim- 
plest forms  of  alcoholic  medicine  may  prove  a  snare, 
and  result  in  the  destruction  of  our  fellow  beings,  I 
here  insert  a  narrative,  from  the  Life  of  Dr.  Adam 
Clarke,  just  published,  of  a  circumstance  with  which 
he  became  personally  acquainted,  and  one  which  has 
had  many  parallels  in  this  country. 

"A.  B.  and  his  wife  C.  B.  were  members  of  the  Me- 
thodists' society,  in  Portsmouth  Common,  and  in  de- 
cent and  respectable  circumstances.  C.  B.  was  fre- 
quently troubled  with  indigestion,  and  consequent 
flatulencies.  A  female  neighbour  said  to  C.  B.,  '  There 
is  a  very  fine  bottle  which  has  done  me  much  good, 
and  T  was  just  as  you  are ;  and  1  am  sure  it  would 
do  you  much  good  also.  Do  try  but  one  bottle  of  it.' 
'  What  do  you  call  it  V  '  Godfrey's  Cordial:  '  Well,  I 
will  try  it,  in  God's  name,  for  I  am  sadly  troubled, 
and  would  give  any  thing  for  a  cure,  or  even  for  ease.' 
A  bottle  of  this  fine  spirituous  saccharine  opiate  was 
bought  and  taken  semndem  artem  :  and  it  acted  as  an 
elegant  dram!  'O  dear,  this  is  a  very  fine  thing;  it 
has  done  me  good  already  ;  I  shall  never  be  without 
this  in  the  house.'  A  little  disorder  in  the  stomach 
called  the  bottle  again  into  request :  it  acted  as  before, 
and  got  additional  praises.  By  and  by  the  husband 
himself  got  poorly  with  a  pain  in  his  stomach  and 
bowels;  the  wife  said,  -Do,  A.,  take  a  little  of  my 


82 


APPENDIX. 


bottle,  it  will  do  you  much  good.'  He  took  it ;  but 
then,  as  he  was  a  man^  it  must  be  a  stronger  dose. 
'  AVelL  C.  this  is  a  very  fine  thing,  it  has  eased  me 
much."  Though  the  wife  was  not  cured,  yet  she  was 
very  much  relieved  !  So  bottle  after  bottle  was  pur- 
chased, and  taken  in  pretty  quick  succession.  The 
husband  found  it  necessary  also  to  have  frequent  re- 
course to  the  same  :  and  now  they  could  both  bear  a 
double  dose  :  by  and  by  it  was  trebled  and  quadru- 
pled :  for  former  doses  did  not  give  relief  as  usual, 
but  the  increased  dose  did.  rso  customers  to  the  quack 
medicine  venders  were  equal  to  A.  B.  and  his  wife. 
They  had  it  at  last  by  the  dozen,  if  not  by  the  gross  ! 
Soon,  scores  of  pounds  were  expended  on  this  carmi- 
native opiate,  till  at  last  they  had  expended  on  it  their 
whole  substance.  Even  their  furniture  went  by  de- 
grees, till  at  last  they  were  reduced  to  absolute  want, 
and  were  obliged  to  take  refuge  in  the  poor  house. 
Here  they  were  visited  by  some  pious  people  of  the 
society :  saw  their  error,  deplored  it.  and  sought  God 
for  pardon.  A  good  report  was  brought  of  tins  mise- 
rable couple  to  the  society  :  it  was  stated  that  they 
saw  their  folly,  and  were  truly  penitent;  and  it  was 
a  pity  to  permit  a  couple,  who  in  all  human  proba- 
bility had  much  of  life  before  them,  to  linger  it  out 
uselessly  in  a  wretched  work  house.  A  collection 
was  proposed  for  their  relief  among  the  principal 
friends ;  it  was  productive,  for  a  considerable  sum 
was  raised.  They  were  brought  out,  placed  in  a 
decent  little  dwelling,  and  a  proper  assortment  of 
goods  purchased  with  the  subscription  already  men- 
tioned, and  they  were  set  up  in  a  respectable  little 


APPENDIX. 


83 


shop.  Many  of  the  friends  bound  themselves  to  give 
A.  B.  and  his  wife  their  custom;  they  did  so.  and  the 
capital  was  soon  doubled,  and  they  went  on  in  reli- 
gious and  secular  things  very  prosperously.  Unfor- 
tunately, the  wife  thought  her  indigestion  and  flatu- 
lencies had  returned,  were  returning,  or  would  soon 
RETURN ;  and  she  once  more  thought  of  Godfrey^s 
Cordial  with  desire  and  terror.  '  I  should  have  a  bot- 
tle in  the  house :  surely  I  have  been  so  warned  that 
I  am  not  likely  to  make  a  bad  use  of  it  again.'  '  C, 
I  am  afraid  of  it,'  said  the  husband.  •  My  dear,'  said 
she,  'we  have  now  experience,  and  I  hope  we  may 
both  take  what  will  do  us  good,  and  that  only.'  Xot 
to  be  tedious,  another  bottle  was  bought,  and  ano- 
ther, and  a  dozen,  and  a  gross ;  and  in  this  they  once 
more  drank  out  all  their  property,  and  terminated 
their  lives  in  Portsmouth  Common  work  house  ! 

"  The  reader  may  be  astonished  at  this  infatuation  ; 
but  he  may  rest  assured  that  the  case  is  not  uncom- 
mon :  Daffy's  Elixir,  Godfrey  s  Cordial,  and  Solo??ion's 
Balm  of  Gilead,  have  in  a  similar  manner  impover- 
ished, if  not  destroyed,  thousands.  On  this  very 
principle  they  are  constructed.  They  are  intended  to 
meet  the  palate,  and,  under  the  specious  name  of 
medicAjies,  they  are  actually  used  as  drams ;  and  in 
no  few  cases  engenders  the  use  of  each  other.  Thus 
drops  beget  drams,  and  drams  beget  more  drops  :  and 
they,  drams  in  their  turn,  till  health  and  property 
are  both  destroyed  ;  and,  I  may  add,  the  soul  ruined 
by  these  truly  infernal  composts.  It  would,  it  is  true, 
be  easy  to  expose  them  :  and  it  is  difficult  to  refrain : — 

''Difficile  eat  Safiram  non  scribere.  nam  qiiis  iniquce 
Tarn  paiiens  urbis,  tamftrreus,  ut  ieneat  se?' 


84 


APPENDIX. 


But  who  dares  do  this?  The  iniquity  is  licensed  by 
the  state :  and  government  makes  a  gain  hy  taxation 
of  that  which  is  destroying  the  lives  and  morals  of 
the  subjects !" 

The  experience  of  mankind  having  demonstrated, 
that  the  use  of  the  class  of  alcoholic  medicines  de- 
nominated Tinctures,  have  produced  such  calamitous 
results  ;  it  is  not  to  be  wondered  at,  that  the  philan- 
thropists who  are  now  waging  war  against  intem- 
perance, should  call  upon  the  Faculty  for  protection 
from  this  subtle  enemy,  whose  mischiefs  have  become 
so  apparent.  And  the  recommendation  to  substitute 
watery  infusions,  decoctions,  or  acetous  tinctures, 
for  those  now  in  use  which  are  prepared  with  alco- 
hol, is  neither  unnatural  nor  unreasonable.  If  one 
in  a  thousand,  or  one  in  ten  thousand,  of  those  to  whom 
we  give  these  tinctures,  thereby  contract  an  appetite 
for  their  use,  which  results  in  the  ruin  of  an  indivi- 
dual by  drunkenness,  much  less  that  of  a  family,  it 
is  an  evil  for  which  none  of  the  specific  virtues  of 
alcoholic  medicines  can  ever  compensate,  and  one 
which  ought  to  be  annihilated  if  need  be,  by  the 
utter  extermination  of  all  such  preparations  from  our 
dispensatories  and  pharmacopoeias. 

But  this  direct  mischievous  result  of  alcoholic  pre- 
parations is  insignificant  in  comparison  with  the  evil, 
considered  in  a  difi'erent  point  of  view.  The  medical 
use  of  ardent  spirits  is  now  the  only  use  which  en- 
lightened or  intelligent  men  can  admit  to  be  neces- 
sary or  advantageous.  Hence,  in  reply  to  every  pro- 
position of  banishing  the  article  from  the  land,  it  is 
strenuously  urged,  that  it  is  highly  important  and 


APPENDIX. 


85 


even  indispensable  as  a  medicine,  and  llierefore  its 
traffic  and  manufacture  is  defended  and  defensible. 
This  idea  of  its  being  indispensable  as  a  medicine  is 
so  universally  prevalent,  that  the  pledges  of  Tempe- 
rance Societies  are  most  generally  conformed  thereto, 
not  because  of  any  mental  reservation  in  most  cases, 
but  to  relieve  tender  and  sensitive  consciences.  This 
is  the  origin  of  the  phraseology  of  these  several 
pledges,  "  except  in  case  of  sickness,"  necessity,  or  the 
like ;  or  the  language  now  used  by  the  American 
Temperance  Society,  pledging  against  the  traffic  and 
use  of  ardent  spirits  as  a  drink.'^  Now  all  these 
exceptions  are  so  many  saving  clauses,  founded  on 
the  implied  idea  that  the  medical  use  is  indispensable, 
an  idea  which  I  fearlessly  affirm  is  unfounded  in  fact. 

I  will  not  assume  that  a  single  draught  of  ardent 
spirits  may  not  have  been  often  useful  in  various  dis- 
eases, nor  that  it  has  not  frequently  preserved  from 
sudden  death  under  some  circumstances,  when  no 
more  suitable  agent  was  at  hand.  Indeed  I  will 
admit  all  that  the  advocates  for  rum  as  a  medicine 
can  claim  for  it,  founded  upon  such  instances,  and 
yet  I  deny  that  it  is  ever  indispensable.  I  can  effect 
by  other  and  innocent  agents  every  thing  in  reliev- 
ing disease,  that  can  be  effected  with  any  form  of 
ardent  spirits :  and  every  well  educated  physician 
knows,  that  our  art  has  resources  adequate  to  meet 
any  possible  emergency,  if  the  art  of  distillation,  with 
all  its  products,  were  annihilated  forever.  It  is  idle 
then  to  pretend,  that  the  manufacture  and  traffic  in 
ardent  spirits  must  necessarily  continue,  because  its 
medical  use  is  indispensable.     A  case  frequently 


86 


APPENDIX. 


named,  as  illustrating  the  value  of  spirituous  liquors, 
is  that  which  is  founded  on  the  sudden  deaths  which 
are  reported  every  summer  as  occurring  from  drink- 
ing cold  water ;  and  it  is  urged  that  a  little  brandy 
taken  with  the  water,  would  prevent  these  casual- 
ties ;  and  still  farther,  it  has  been  found,  that  persons 
have  been  recovered  from  the  alarming  dangers  pro- 
duced by  drinking  cold  water  when  heated,  by  quickly 
swallowing  a  draught  of  raw  brandy.  And  hence 
it  is  argued,  that  in  hot  weather  ardent  spirits  in  the 
water  drank  is  useful,  and  for  the  effects  of  drinking 
water  alone  ardent  spirits  are  indispensable. 

The  argument  however  is  unsound,  and  the  illus- 
tra'tion  an  unhappy  one.  if  it  be  recollected,  that  the 
instances  of  sudden  death  from  drinking  cold  water, 
almost  universally  occur  among  intemperate  foreign- 
ers, or  others  who  habitually  indulge  in  the  use  of  spi- 
rituous liquors.  And  after  drinking  as  usual  until  a 
thirst  is  thus  created  which  rum  will  not  gratify,  they 
go  to  a  pump  or  spring  of  water,  and  drink  to  allay 
this  thirst,  which  is  more  from  their  intemperance, 
than  from  labour  and  heat  united.  Such  are  most 
generally  the  facts  in  the  instances  referred  to,  as  is 
well  understood  by  those  who  have  attended  to  the 
subject. 

The  effect  of  the  cold  thus  suddenly  applied  to  the 
stomach,  is  supposed  to  be  a  paralysis  extending  from 
that  organ  to  the  heart,  and  hence  a  powerful  stimu- 
lus, promptly  administered,  is  the  usual  remedy.  For 
this  purpose,  opium,  capsicum,  camphor,  ammonia, 
and  the  like,  have  all  been  successfully  employed, 
and  either  are  preferable  to  alcohol  for  this  purpose. 


APPENDTX.  87 

especially  when  the  patient  often  has  half  a  pint  of 
rum  in  his  stomach  at  the  time  of  the  accident,  as  I 
have  known  to  be  the  case  more  than  once ;  and  in 
such  cases,  it  is  somewhat  unaccountable  how  the 
mixture  of  rum  and  water  before  drinking  it,  is  to 
frevent  the  accident,  and  mixing  it  in  the  stomach  is 
to  cure  it ;  but  this  may  be  regarded  as  another  spe- 
cimen of  rum  logic  and  alcoholic  philosophy. 

The  truth  is,  that  water,  however  cold,  drank  by 
an  individual  however  much  heated,  never  did  pro- 
duce this  paralysis  and  death,  except  when  the  sto- 
mach had  previously  been  impaired  by  intemperance 
or  otherwise,  and  hence  these  accidents  proverbially 
occur  among  drunkards.  And  it  is  equally  true,  that 
in  these,  when  the  effect  of  drinking  cold  water  can 
be  relieved,  there  are  other  remedies  more  immediate 
and  effectual  than  alcohol,  so  that  it  is  by  no  means 
indispensable  even  under  such  circumstances.  Among 
the  hundreds  of  thousands  who  practise  total  absti- 
nence from  all  intoxicating  drinks,  there  cannot  be 
an  instance  produced  of  death  from  drinking  cold 
water,  although  they  usually  drink  it  more  frequently 
and  more  liberally  when  heated,  than  do  the  intem- 
perate. They  are  perhaps  for  the  most  part  more 
discreet  than  to  use  any  thing  to  excess,  and  if  they 
should  even  trespass  in  this  respect,  with  cold  water, 
the  only  evil  effects  that  would  follow,  are  a  tempo- 
ary  disturbance  of  the  system,  neither  dangerous  nor 
fatal.  The  stomach  v.nimpaired  by  artificial  stimu- 
lation, has  ordinarily  vigour  enough  to  reject  the  wa- 
ter or  overcome  the  effects  of  its  temperature. 

The  pretext  for  mixing  alcohol  with  water,  be-^ 


88 


APPENDIX. 


cause  of  its  bad  quality,  as  is  proverbial  in  New 
York,  is  alike  unfoundedj  for  there  is  no  quality  so 
bad  in  the  water  as  this  imparts  to  it ;  and  certainly 
none,  to  which  this  is  an  antidote.  And  yet  in  this 
city  there  are  many  barrels  of  ardent  spirits  in  its 
varied  forms,  which  are  medically  used  on  this  pre- 
text, and  then  forsooth  all  the  mischiefs  of  the  rum 
are  set  down  to  our  villanous  pump  water."'  The 
bar  keepers  of  our  hotels,  taverns,  and  other  grog 
shops,  find  it  their  interest  to  cry  down  the  water, 
and  pronounce  panegyrics  on  the  virtues  of  mixing 
it,  especially  for  strangers,  who  are  earnestly  caution- 
ed against  using  pump  water,  without  its  being  first 
made  into  punch,  sling,  or  bitters.  It  is  on  this  ac- 
count that  a  single  visit  to  our  city,  has  been  so  often 
the  ostensible  cause  of  manufacturing  drunkards,  for 
persons  have  here  learned  to  drink  rum  as  a  remedy 
for  bad  water  so  well,  that  on  their  return  home,  they 
could  not  unlearn  it,  and  have  never  found  any  water 
since  good  enough  to  dispense  with  the  addition, 
which  they  found  so  exhilarating  and  medicinal.  I 
have  often  been  amused  at  the  willingness  manifest- 
ed to  take  this  medicine^  even  by  those  who  abhor 
physic  in  all  its  forms,  and  however  sensitive  or 
delicate  the  stomach  in  refusing  castor  oil  and  jalap, 
this  kind  of  medicine  seldom  excites  any  nausea  or 
disgust,  and  hence  it  is  given  to  cover  the  taste  of 
other  drugs,  until  it  has  become  an  almost  universal 
panacea. 

But  still  another  and  greater  evil  results  from  this 
error,  which  is,  that  thousands  of  those  who  love 
rum,  are  daily  drinking  it  as  a  medicine  for  the  cure 


APPENDIX. 


89 


of  imaginary  diseases,  or  for  the  relief  of  real  mala- 
dies, which  its  use  as  a  medicine  is  not  only  increas- 
ing, but  has  absolutely  created.  Indeed,  scarcely 
any  man,  having  pretensions  to  character,  will  pub- 
licly call  for,  or  drink  a  single  glass  of  spirits,  with- 
out complaining  of  indisposition  as  his  apology  for 
drinking  it  as  medicine.  Hence  the  varied  and  even 
opposite  excuses  which  are  offered  for  drinking,  such 
as  pain  or  sickness  at  the  stomachy  want  of  appetite, 
indigestion,  chilliness,  headache,  inability  to  sleep^  wea- 
riness, idleness,  dry  or  wet,  hot  or  cold  weather,  hard 
work,  or  nothing  to  do,  soft  or  hard  \cater,  and  the  like 
frivolous  pretences  ;  and  in  all  such  cases,  it  is  taken, 
not  as  a  drink,  but  only  as  a  inedicine.  Thus,  the  ha- 
bitual use  of  spirituous  liquors  in  a  vast  proportion  of 
the  cases  in  which  it  is  now  drank,  is  the  result  of 
the  medical  use,  by  which  men  are  taught  that  it  is 
not  only  right  to  drink  rum,  but  useful  and  necessary. 
And  at  this  crisis  in  the  onward  march  of  the  tem- 
perance reformation,  it  is  plain  that  nearly  all  the 
drunkenness  of  the  future  generation  might  be  pre- 
vented but  for  its  medical  use. 

And  here  it  may  be  appropriately  remarked,  that 
the  opinion  of  the  indispensable  necessity  for  ardent 
spirits  is  fortified  by  another  sentiment,  which  is  as 
erroneous  and  absurd  as  any  other  of  the  vulgar  er- 
rors we  have  been  deprecating.  It  has  been  repeat- 
ed ten  thousand  times,  until  it  has  grown  into  a  pro- 
verb, that  those  persons  who  have  daily  and  habitu- 
ally accustomed  themselves  to  drinking  spirituous 
liquors,  even  if  they  desire  to  abandon  the  vice,  and 
however  many  motives  may  justly  impel  them  to 
12 


90 


APPENDIX. 


reformation,  must  not  quit  suddenly,  but  continue  to 
drink  it  as  a  medicine,  gradually  and  very  cautiously 
reducing  the  quantity,  little  by  little.  Indeed,  they 
are  told  that  to  quit  drinking  suddenly  will  endan- 
ger their  health,  and  even  destroy  life  itself;  and 
marvellous  instances  are  often  related  of  drunk- 
ards who  have  abandoned  their  habits  suddenly, 
and  very  soon  perished  for  want  of  a  little  alcohol  as 
a  medicine.  Such  stories  are  fictitious  universally, 
by  whomsoever  told :  and  yet,  while  they  are  believ- 
ed and  acted  on,  the  drunkenness  of  the  drunken 
will  be  perpetuated  for  ever,  for  the  very  obvious  rea- 
son, that  he  who  undertakes  to  quit  drinking  rum 
little  by  little  will  never  quit  at  all.  I  have  known 
hundreds  of  instances  of  reformations  being  at-  ' 
tempted  after  this  manner,  and  I  never  knew  or  heard 
of  a  successful  one. 

This  false  notion  is  most  pernicious  in  the  man- 
agement of  the  disease  peculiar  to  drunkards,  called 
mania  a  potu.  or  deViriiun  tremens,  familiarly  known 
by  the  name  of  horrors.  "  It  is  most  generally  at- 
tributed by  the  patient  and  his  friends  to  the  want 
of  rum : — but  is,  in  fact,  the  result  of  repeated  ex- 
cesses having  overthrown  both  the  brain  and  ner- 
vous system,  and  involved  all  the  powers  of  life  in  a 
drunken  phrenzy.  The  attack  most  generally  exhi- 
bits itself  after  a  ••'  hard  frolic,"  when  the  patient  has 
been  lying  for  hours  in  a  stupor  almost  apoplectic. 
When  he  arouses  from  this  lethargy  he  is  delirious, 
begins  to  mutter,  and  exhibits  marks  of  fright.  He 
sees  continually  before  him  assassins  and  fiends  who 
are  come  to  torment  him,  struggles  convulsively,  and 


APPENDIX. 


91 


often  shrieks  in  agony,  while  a  cold  sweat  is  stream- 
ing from  his  body.  From  this  state  he  often  rouses 
to  the  rage  and  fury  of  a  demoniac ;  and  yet,  in  his 
lucid  intervals,  he  will  call  aloud  for  rum,  and  utter 
the  most  horrid  imprecations  and  blasphemy  if  it  is 
withheld. 

While  in  this  shocking  condition,  so  obviou.sly  in- 
duced by  drinking  ardent  spirits,  as  shown  in  the 
fact  that  the  array  of  symptoms  peculiar  to  these 
horror.s"'  is  never  produced  from  any  other  cause, 
his  friends  often  give  him  more  of  the  poi-son  which 
has  so  nearly  destroyed  him:  and  physicians  are 
sometimes  found,  who  adopt  this  vulgar  and  mis- 
chievous error,  and  pour  down  rum  ^  medicine ; 
until  the  patient  falls  a  victim  to  the  destroyer  ;  and 
even  then  sagely  account  for  his  death  by  deciding 
that  he  quit  drinking  too  suddenly,  or  that  his  sto- 
mach would  not  receive  any  more  of  his  infernal  me- 
dicine, as  it  is  frequently  rejected  by  this  organ  un- 
der such  circumstances. 

Plausible  and  popular  as  is  this  practice,  every 
man  of  sense  in  the  profession  knows  full  well  that 
it  is  both  cruel  and  absurd  :  and  that  it  would  be  as 
rational  to  attempt  to  extinguish  fire  by  piling  on 
fuel,  as  to  cure  the  disease  arising  from  rum  by  giv- 
ing more  rum.  The  only  difference  is,  that  the  cause 
of  the  disease  was  taking  rum  as  a  drink :  w^hile  its 
cure  is  found  in  taking  rum  as  a  medicine: — a  very 
important  distinction  truly,  and  one  worthy  of  capi- 
tals and  italics.  In  sober  truth,  however,  this  disease 
is  incurable  while  its  cause  is  persevered  in  :  and  the 
numerous  deaths  which  are  reported  from  delirium 


92 


APPENDIX. 


tremens  are  most  frequently  the  result  of  this  medical 
use  of  some  form  of  spirituous  liquors,  which  is  given 
on  the  false  and  absurd  idea,  that  it  is  not  safe  sud- 
denly to  withhold  the  accustomed  stimulus ;  for  un- 
der judicious  treatment  this  disease  is  seldom  fatal, 
except  after  a  frequent  repetition  of  the  attack. 

If  there  were  any  danger  from  suddenly  abandon- 
ing the  use  of  rum,  why  is  it  not  exhibited  in  the 
multitude  of  drunken  vagrants  who  throng  our  peni- 
tentiary, and  in  the  thousands  of  drunkards  who  crowd 
our  State  prisons  ?  These  all  quit  suddenly,  and  yet 
who  ever  heard  of  either  health  or  life  having  suffer- 
ed thereby  ?  The  notion  Is  unworthy  of  sober  refu- 
tation, and  is  only  named  because  it  is  one  of  the 
hydra-headed  sources  of  this  medical  use  of  alcohol. 

On  the  physicians  of  this  country,  therefore,  the 
hopes  of  posterity  depend,  and  to  them  this  cause  of 
philanthropy  and  benevolence  now  imploringly  ap- 
peals. If  our  profession  will  nobly  espouse  the  cause 
of  Temperance,  by  expelling  from  the  practice  of 
physic  all  alcoholic  preparations  of  medicines  ;  and 
unite  their  combined  testimony  in  favour  of  the  truth, 
that  the  medical  use  of  ardent  spirits  can  be  wholly 
dispensed  with,  not  only  without  detriment,  but  with 
incalculable  advantage  to  the  public  health  ;  then 
shall  we  acquit  ourselves  of  the  fearful  amount  of 
responsibility  which  is  accumulating  upon  us  for  the 
propagation  of  this  ruinous  and  fatal  delusion,  that 
the  traffic  and  use  of  ardent  spirits  must  be  continued, 
because  indispensable  in  medicine.  Better  for  the 
health  and  lives  of  the  community,  that  the  very 
name  and  existence  of  the  medical  profession,  should 


APPENDIX. 


93 


be  driven  from  the  land  or  blotted  out  for  ever,  than 
that  we  should  entail  this  stupid  deception  and  mis- 
chievous imposition  upon  the  nation  and  the  world. 
For  even  the  advocates  for  the  medical  use  of  rum 
must  admit  the  obvious,  though  appalling  truth,  that 
more  lives  are  lost  by  drinking  rum  as  a  medicine  in 
a  single  year,  than  are  preserved  by  it  in  a  century. 

The  solitary  instances  of  immediate  relief  in  sud- 
den and  dangerous  diseases,  which  have  occurred 
from  a  single  dose  of  ardent  spirits,  is  no  argument 
for  the  necessity  of  keeping  it  in  the  house  in  readi- 
ness for  such  an  emergency.  Who  has  not  seen  in- 
stances of  the  application  of  scalding  water,  and  the 
actual  cautery,  to  the  skin,  in  sudden  and  dangerous 
conditions  of  the  body,  successful  in  preserving  life? 
And  yet  no  one  proposes  to  keep  a  kettle  perpetually 
boiling,  or  a  red  hot  iron  day  and  night  in  the  house, 
that  these  agents  may  always  be  accessible.  And 
yet  the  cures  reported  by  the  application  of  fire  in 
desperate  attacks  of  disease,  are  quite  as  nume- 
rous as  any  authenticated  cases  of  similar  cha- 
racter which  have  been  cured  by  rum,  and  there 
would  be  as  much  propriety,  therefore,  in  the  timely 
provision  of  the  one  remedial  agent  as  the  other. 
The  truth  is,  that  this  is  the  last  and  only  hold 
which  rum  has  upon  the  public  mind,  and  on  us  de- 
volves the  tremendous  responsibility  of  loosing  its 
grasp,  or  bearing  the  reproach  of  its  consequences. 

If,  however,  physicians  will  not  perform  their  duty 
from  the  paramount  motives  so  calculated  to  impel 
them  to  it,  the  hopes  of  humanity  need  not  thus  be 
overthrown ;  for  the  mighty  influence  of  truth  will 


94 


APPENDIX. 


gradually  but  certainly  put  them  down  by  the  force 
of  public  opinion.  The  true  light  on  this,  as  on  other 
subjects  involving  the  physical  and  moral  regenera- 
tion of  the  world,  is  now  shining,  and  is  destined  to 
dispel  the  clouds  of  ignorance  and  imposture,  which 
still  linger  upon  the  minds  of  men,  even  at  the  ex- 
pense of  the  craft.  Neither  priest-craft  nor  the  doc- 
tor-craft can  longer  bind  the  restless  exertions  of  in- 
quiry, and  both  the  one  and  the  other  profession  must 
yield  their  dogmatisms  to  the  light  of  truth,  and 
maintain  their  authority  by  a  corresponding  conform- 
ity to  the  genius  of  the  age ;  or  neither  will  be  able 
any  longer  to  control  by  the  one,  or  maintain  by  the 
other  ;  and  they  and  their  useful  professions  must 
succumb  to  the  spirit  of  reformation  which,  in  these 
respects,  possesses  the  attribute  of  Omnipotence.  I 
have  no  fear,  however,  that  the  medical  profession, 
enlightened  and  liberal  as  it  has  become  in  this  coun- 
try, will  be  far  behind  the  spirit  of  the  age.  So  soon 
as  the  important  bearing  upon  the  temperance  cause, 
which  the  medical  use  of  ardent  spirits  is  occasion- 
ing, is  felt  and  appreciated,  physicians  will  every 
where  proscribe  it  from  their  practice.  This  being 
done,  the  public  will  begin  to  feel  and  act  for  the 
banishment  of  an  article  from  the  nation,  which  is 
productive  of  no  good  in  sickness  or  in  health;  but  the 
effects  of  which,  upon  individuals,  families,  and  the 
community — upon  the  body  and  the  soul,  are  ^^evil, 
only  evil,  and  thai  continually.''' 

It  is  objected  by  some,  that  as  laudanum,  parego- 
ric, and  other  tinctures,  the  nature  and  properties  of 
which  are  now  familiar  to  every  family,  are  pre- 


APPENDIX. 


95 


pared  with  alcohol  as  a  menstruum;  and  as  the  resi- 
nous properties  of  gums  will  not  yield  to  watery  in- 
fusions, that  it  will  be  impossible  to  lay  aside  this 
large  class  of  remedial  means,  called  Tinctures.  I 
have  already  intimated  my  own  personal  conviction 
that  if  alcoholic  medicines  were  only  used  in  these 
forms,  and  in  doses  not  exceeding  a  few  drops,  the 
influence  and  effects  would  be  imperceptible,  and 
consequently  no  danger  could  be  apprehended.  But  it 
is  a  melancholy  fact,  that  some  of  these  tinctures  are 
used  in  the  manufacture  of  drunkards  to  a  fearful 
extent;  and  the  examples  of  habitual  intoxication, 
by  taking  increased  and  increasing  doses  of  lauda- 
num, paregoric,  and  the  like,  are  so  frequent  as  to  ad- 
monish us  of  their  pernicious  tendency;  and  although 
in  other  cases,  as  in  that  of  Godfrey's  cordial,  which 
has  been  mentioned,  the  effect  is  that  of  opium  ra- 
ther than  alcohol,  still  the  pleasurable  exhilaration 
produced  is  of  the  same  kind  in  both  cases,  because 
these  narcotic  poisons  are  analogous  in  their  nature 
and  effects.  The  use  of  rum,  as  a  medicine  creates 
a  morbid  appetite,  not  only  for  itself,  but  for  opium 
and  all  other  narcotic  agents,  and  hence  those  who 
begin  with  ardent  spirits,  often  end  in  some  more 
mischievous  medicine,  if  such  a  one  can  be  found  in 
the  materia  medica. 

Nevertheless,  the  evils  produced  by  retaining  the 
whole  of  the  tinctures,  and  persisting  in  their  use, 
would  be  of  small  importance ;  and  indeed  they  dwin- 
dle into  insignificance,  when  compared  with  the  me- 
dical use  of  the  different  forms  of  ardent  spirits  in 
various  real  or  imaginary  diseases.  And  yet  it  is  ob- 


96 


APPENDIX. 


jected  to  their  abandonment,  not  merely  that  they 
have  often  been  convenient  and  useful  in  sudden 
emergencies,  but  that  their  stimulating  quality  is 
useful  in  cases  of  general  dehUity,  from  whatever 
cau^e ;  and  many  attribute  to  them  a  tonic  and  invi- 
gorating attribute,  which  in  many  constitutions  is 
said  to  be  innocent  and  salutary.  In  opposition, 
however,  to  this  sentiment,  we  have  the  fact,  that  this 
world  was  peopled,  some  thousands  of  years,  by  a 
healthy,  vigorous,  and  athletic  population,,  before  the 
art  of  distillation  supplied  them  with  this  medicine : 
and  the  additional  fact,  that  among  the  hundreds 
of  thousands  in  our  country  who  totally  abstain, 
these  tonic  and  invigorating  eiTects  of  it  are  never 
called  for.  And  beside,  these  facts,,  it  cannot  be  de- 
nied, that  their  stimulating  and  exciting  efTectsupon 
the  stomach,  and  upon  the  general  circulation,  however 
closely  resembling  those  of  health,  are  unnatural  and 
essentially  different  in  character  from  the  excitement 
accompanying  a  salutary  state  of  the  system. 

But  even  if  ardent  spirits,  used  strictly  as  a  medi- 
cine, were  possessed  of  all  these  virtues,  still  I  would 
contend  for  their  entire  relinquishment,  if  for  no  other 
reason,  than  that  this  medical  use.  while  it  continues 
to  receive  the  sanction  of  the  wise  and  good,  gives 
origin  and  perpetuation  to  all  the  accumulating  evils 
of  intemperance.  It  can  never  be  made  generally  dis- 
reputable, either  to  traffic  in  spirituous  liquors,  or  to 
use  them,  while  they  are  admitted  to  be  drank  daily 
and  habitually  as  a  medicine,  either  by  those  who  are 
really  sick,  or  fancy  themselves  to  be  so. 

This  will  be  evident,  if  we  consider  that  a  verv^ 


APPENDIX. 


97 


great  majority  of  mankind  are  at  all  times  in  one  of 
these  conditions.  By  excessive  eating-,  or  other  im- 
prudences of  living,  more  than  half  our  adult  popu- 
lation are  complaining  more  than  half  the  time  ;  and 
alcohol,  in  some  form,  as  a  medicine,  is  the  remedy 
more  frequently  resorted  to.  than  the  physician,  or 
the  legitimate  resources  of  his  art.  Indeed,  for  little 
ailments,  as  the  first  effects  of  excesses  in  living  are 
called,  the  medical  use  of  ardent  spirits  is  almost  uni- 
versal for  children  as  well  as  adults,  and  no  other 
remedy  is  sought,  while  this  affords  a  semblance  of 
relief.  Very  soon  the  medicine  itself,  thus  often  re- 
peated, produces  symptoms  of  disease  more  serious 
than  any  for  which  it  was  prescribed,  and  yet  the 
same  medicine  is  relied  on  for  its  cure.  Such  is  the 
only  philosophy  or  logic  which  now  sustains  the 
whole  fabric  of  alcoholic  medicine. 

Impressed  with  the  importance  of  these  views,  I 
have  resolved  to  throw  them  before  the  public,  and 
hazard  any  criticism  which  they  may  occasion,  either 
from  members  of  my  own  profession,  who  may  ho- 
nestly entertain  difTerent  sentiments,  or  from  the  ad- 
vocates and  apologists  for  rum,  wherever  they  may 
be  found.  If  I  am  correct  in  my  opinions  and  rea- 
soning, then  the  completion  of  the  work  of  the  Tem- 
perance reformation,  in  exterminating  spirituous  li- 
quors from  the  nation  and  the  world,  may  be  looked 
for  at  a  much  earlier  period  than  its  most  sanguine 
friends  have  anticipated.  For  I  repeat  my  convic- 
tion, that  if  the  medical  use  can  be  overthrown,  the 
manufacture,  traffic,  and  use.  of  alcohol,  may  be  at 
once  annihilated  for  ever.    •'•  Truth  is  mighty,  and 


98 


APPENDIX. 


Will  prevail :"  however  long  or  loudly  error  may 
plead  for  triumph. 

If  there  can  be  found  on  the  records  of  the  healing 
art,  or  on  the  page  of  authentic  history,  the  descrip- 
tion of  a  disease  with  which  the  human  hody  was  ever 
afflicted,  or  a  single  symptom  which  ever  presented 
itself,  for  which  there  is  not  a  more  safe  and  effectual 
remedy,  than  is  any  modification  of  alcohol ;  I  confess 
that  in  my  diligent  investigation  of  the  subject  for 
many  years,  and  in  all  the  opportunities  I  have  en- 
joyed in  public  and  private  practice,  I  have  never 
found  any  evidence  of  the  fact,  and  am  willing  that 
any  champion  of  ardent  spirits  may  publish  such  a 
one  to  the  world,  as  an  argnmentum  ad  hominem 
against  all  I  have  written.  Nay,  I  will  go  farther, 
and  add,  that  if  any  candid  and  enlightened  physi- 
cian will  give  a  description  of  a  supposed  case  of  dis- 
ease, which  he  may  fancy  as  occurring  within  the 
limits  of  probabiUti/,  whether  the  patient  have  previ- 
ously been  sober  or  drunken^  and  in  which  any  form 
of  ardent  spirits  is  indispensable^  I  will  give  him 
credit  for  his  ingenuity;  and,  if  I  cannot  refute  his 
argument  founded  upon  this  supposition,  I  will 
magnanimously  proclaim  my  error,  and  retract  the 
aflarmation  of  the  utter  worthlessness  of  the  arti- 
cle, as  a  medicinal  agent. 

But,  let  it  be  remembered,  that  such  a  case,  real  or 
imaginary,  must  exist,  and  must  be  produced,  or  our 
profession  will  be  inexcusable,  if  they  any  longer 
shelter  beneath  their  authority  and  influence,  this 
last  protege  of  the  apologists  and  advocates  for  the 
manufacture,  traffic,  or  use  of  the  greatest  evil  with 


APPENDIX. 


99 


which  tne  world  is  cursed.  Still,  however,  the  last 
and  strongest  plea  for  the  medical  use  of  alcohol,  is 
for  its  external  use  ;  and  which  is  urged  by  some 
with  as  much  zeal,  as  though  there  was  nothing  in 
heaven  above,  or  in  earth  beneath,  which  possessed 
the  sovereign  virtues  of  brandy,  as  an  external  ap- 
plication. Now  it  is  passing  strange,  that  physi- 
cians should  be  found,  who  sanction  this  vulgar  sup- 
position, and  for  various  internal  affections  profess  to 
have  no  other  remedy  than  the  outward  application 
of  fomentations  of  hot  brandy :  when  there  never  has 
been  any  reason  for  its  so  general  use,  but  the  fact, 
that  it  is  always  accessible  in  almost  evi.:y  house, 
and  therefore  a  convenient  remedy  at  all  times.  Its 
effect  upon  the  skin  is  that  of  direct  stimulation  ; 
which  can  be  produced  as  effectually  in  any  disease 
by  vinegar,  or  capsicum,  or  mustard,  or  any  other  of 
the  class  of  rubefacients  ;  and  indeed  these  agents 
are  very  generally  preferable  for  their  curative  pro- 
perties. Nor  is  there  any  one  of  the  multiplied  ail- 
ments for  which  spirituous  liquors  are  thus  exter- 
nally applied,  for  which  there  are  not  other  and  more 
useful  remedies.  This  pretext,  therefore,  for  the  in- 
dispensable necessity  of  the  continuance  of  the  traf- 
fic and  use  of  alcohol  is  therefore,  like  the  rest,  with- 
out foundation ;  apart  from  the  fact  that  too  many  use 
the  same  medicine  outside  and  inside  simultaneously. 
I  have  known  many  persons  who  drank  intempe- 
rately,  wash  their  heads  with  rum,  that  they  might 
account  for  the  presence  of  its  vapour  upon  their  per- 
sons, by  having  used  it  externally  only  as  a  medicine, 
to  keep  their  hair  from  coming  out. 


100 


APPENDIX. 


Indeed,  one  of  the  most  frequent  applications  of 
alcohol  externally  is  to  the  head^  under  the  name  of 
Cologne,  and  other  aromatic  waters^  as  they  are  most 
improperly  called ;  for  they  are  all  composed  of  rec- 
tified alcohol,  and  are  universally  mischievous  to  the 
hair,  especially  by  reason  of  some  of  the  essential 
oils  with  which  they  are  perfumed:  notwithstanding 
they  are  «o  fashionable,  and  so  highly  prized  by  the 
fairer  part  of  creation.  Their  effect  is  not  only  that 
of  burning  the  hair,  but  they  often  produce  disease 
in  the  scalp,  by  which  the  roots  of  the  hair  suffer, 
and  it  falls  out ;  a  mischief  w^hich  is  often  irrepara- 
ble. This,  therefore,  which  is  the  most  fashionable 
medical  use  of  alcohol,  and  in  which  an  immense 
amount  is  consumed  annually  in  this  and  other  coun- 
tries, is  undoubtedly  pernicious,  and  ought  to  be 
wholly  abandoned. 

I  insist,  therefore,  that  unless  it  can  be  demonstra- 
ted that  alcohol  is  necessary  for  some  medical  jnirposcj 
its  existence  among  us  is,  and  its  perpetuation  will 
be,  a  more  bitter  inheritance  for  posterity,  than  Pan- 
dora's box  received  from  Jupiter,  with  which  to  curse 
mankind  :  for  that  had  hope  at  the  bottom,  while 
rum  is  without  one  solitary  redeeming  quality.  Let 
those  who  oppose  its  banishment  from  the  land, 
then,  no  longer  plead  for  its  necessity,  or  even  for  its 
utility:  for  neither  are  defensible  by  a  single  argu- 
ment drawn  from  the  resources  of  earth  or  heaven : 
but  let  them  unblushingly  avow,  if  they  continue  to 
plead  for  its  perpetuation  among  us,  and  for  be- 
queathing its  withering  curse  upon  future  genera- 
tions, that  the  love  of  rum.  and  the  love  of  its  loages^ 


APPENDIX. 


101 


are  paramount  with  them  to  all  the  pauperism,  crime, 
and  unmingled  wretchedness,  it  never  fails  to  inflict 
in  this  life,  and  all  the  hopeless  despair  of  the  life  that 
is  to  come. 

Such  are  the  stupendous  motives  which  prompt 
the  efforts  of  the  friends  of  mankind,  in  their  war- 
fare against  the  demon  intemperance,  that  it  is  ama- 
zing with  what  armour  they  can  be  resisted  ; — mo- 
tives high  as  heaven,  deep  as  hell,  and  immeasurable 
as  eternity.  All  the  bright  and  joyous  hopes  of  man- 
kind here  and  hereafter,  must  wither  and  die,  unless 
this  parent  of  abominations  can  be  driven  from  the 
earth.  And  so  long  as  disease  in  its  variegated  forms 
is  the  lot  of  humanity,  and  the  art  of  healing  conti- 
nues to  deserve  and  receive  the  homage  of  the  world; 
so  long  must  every  medicine  of  real  or  supposed  vir- 
tues continue  to  be  held  in  veneration  and  esteem. 
The  question,  the  momentous  question,  then,  for  this 
generation  to  solve  is,  whether  ardent  spirits  possess 
this  claim  to  immortality,  or  whether  their  medicinal 
virtues,  if  they  have  any,  shall  furnish  a  pretext  for  the 
perpetuation  of  their  irreparable  mischiefs  to  the  bo- 
dies and  the  souls  of  men.  I  affirm  the  negative  of 
this  proposition,  and  with  very  many  of  my  profes- 
sional brethren,  fearlessly  proclaim,  that  the  article 
may  be  safely  and  entirely  exiled  from  the  Materia  Me- 
dica  without  diminishing  our  resources  in  "wrestling 
with  death."  And  whether  we  shall  be  successful  in 
effecting  this  object,  so  soon  as  we  deem  it  desirable 
or  ijnportant,  in  this  country,  or  not ;  there  is  every 
indication  in  the  signs  of  the  times,  that  our  trans- 
atlantic brethren  are  aiming  at  this  result ;  for  since 


102  APPENDIX. 

the  facts  disclosed  by  the  Cholera  in  every  part  of  the 
earth,  over  which  its  march  has  been  witnessed, 
many  of  the  ablest  physicians  of  England,  and  some 
in  India,  have  strenuously  urged  the  necessity  of 
utterly  proscribing  its  manufacture  and  traffic  by 
legislative  authority,  and  prohibiting  its  use  among 
the  people  by  penal  enactments.  And  the  proposi- 
tion of  abolishing  alcohol  from  medicine,  and  remo- 
ving all  its  compounds  from  the  dispensatories,  has 
found  many  advocates  in  England  as  well  as  in  this 
country;  so  that  a  Temperance  Pharmacopoeia  and 
Materia  Medica."  may  ere  long  be  introduced  into 
both  countries  simultaneously,  and  the  way  is  pre- 
paring by  recent  events  so  rapidly,  that  it  will 
excite  neither  indignation  nor  surprise. 

Still,  however,  physicians  may  abolish  it  from  their 
catalogues  of  remedial  means,  and  dispense  with  those 
•compounds  of  which  alcohol  is  the  menstruum,  and 
the  medical  use  of  ardent  spirits  will  not  then  be 
annihilated.  For  justice  to  our  profession  requires  it 
to  be  understood,  that  but  a  very  small  part  of  the 
medicinal  use  of  alcohol  is  taken  by  our  advice,  but  ve- 
ry much  indeed  is  taken  directly  in  opposition  to  that 
advice.  In  this  department,  more  than  any  other,  it  may 
be  said,  that  every  man  is  his  own  doctor,  for  those  who 
would  not  take  a  dose  of  salts  or  castor  oil,  without  the 
best  professional  advice,  will  nevertheless  not  scruple 
to  take  brandy  or  gin  as  a  medicine :  because,  forsooth, 
it  is  so  innocent  that,  with  this  kind  of  physic,  they  can 
prescribe  for  themselves:  and  because,  moreover,  they 
need  a  repetition  of  the  dose  more  frequently  than  it  is 
convenient  to  see  the  doctor  or  economical  to  fee  him. 


APPENDIX. 


103 


And  now,  to  the  real  friends  of  temperance  scat- 
tered over  the  land,  I  would  affectionately  urge  the 
importance  of  combining  the  influence  of  their  exam- 
ple against  the  use  of  ardent  spirits,  not  only  "  as  a 
drink^^^  but  "  as  a  medicine^^  for  in  this  way  only  can 
the  doctrine  of  "  total  abstinence"  be  consistently 
maintained,  and  in  this  way  only  can  we  hope  for 
success  in  banishing  the  accursed  thing  from  the 
country  and  the  world. 

I  have  said  little  about  wine  or  beer,  except  under 
the  generic  name  alchohol^  of  which  these  are  the 
species.  The  one  is  the  lion,  the  other  are  the  whelps, 
and  if  the  former  is  destroyed  and  declared  by  public 
sentiment  to  be  neither  good  for  food  nor  physic,  the  lat- 
ter, and  all  the  modifications  of  distilled  and  ferment- 
ted  liquors,  will  soon  share  the  same  fate.  Already  a 
wine-drinking,  beer-tippling  advocate  for  temperance, 
is  becoming  an  off"ence  in  the  public  estimation,  and  the 
recent  desperate  effort  made  by  professional  men,  as 
well  as  others,  to  elevate  wine,  and  especially  beer,  as 
possessing  medicinal  qualities  preventive  of  Cholera 
and  the  like,  are  beneath  contempt,  and  only  serve  to 
show  the  dying  struggles  of  alcoholic  medicines  for  a 
name  and  place  among  men. 

To  my  professional  brethren  I  commend  this  whole 
subject  as  one  woi  thy  of  their  deliberation  and  energe- 
tic action.  If  they  shall  see  this  matter  in  the  light  in 
which  it  appears  to  my  mind,  and  concur  with  me 
in  the  utter  worthlessness  as  well  as  direful  mischiefs 
of  alcohol  as  a  medicine,  I  call  upon  them  to  proclaim 
it  by  their  united  testimony  and  example.  Such  an 
effort  on  our  part  would  secure  the  favour  of  the  wise 


104 


APPENDIX. 


and  virtuous,  which  is  the  only  popularity  worthy 
either  pursuit  or  possession. 

Besides,  I  would  urge  the  importance  of  the  sub- 
ject upon  physicians  from  the  fact,  which  it  would 
be  affectation  to  conceal,  that  too  many  of  our  pro- 
fession have  brought  reproach  upon  the  fraternity, 
and  ruin  on  their  reputation,  by  themselves  fall- 
ing victims  to  intemperance.  Whether  this  be  a 
just  retribution  on  us  for  making  so  many  drunk- 
ards among  our  patients,  or  whether  it  be  the  effect  of 
the  accursed  habit  in  the  families  we  visit,  of  offer- 
ing us  the  decanter  every  time  we  enter  their  houses, 
it  is  not  now  my  province  to  inquire.  But  I  call  upon 
my  brethren  who  have  escaped  the  pestilential  influ- 
ence of  intemperance,  to  look  around  them  and  see 
how  many  great  men  have  fallen ;  how  many  giant  in- 
tellects are  among  us  tottering  to  their  fall ;  and  how 
many  learned  and  distinguished  physicians  are  the 
known  martyrs  of  inebriation.  Humanity  shudders, 
and  the  genius  of  our  profession  weeps  over  the  un- 
happy, the  melancholy  truth,  that  some  of  those  who 
once  were  an  honour  to  our  science,  and  ranked  among 
our  public  benefactors,  have,  by  ardent  spirits,  become 
prematurely  superannuate ;  and  we  are  compelled  to 
bestow  all  our  eulogy  on  the  vigour  of  their  youth,  and 
become  the  encomiasts  of  their  former  achievements. 
Would  to  God  their  epitaph  had  been  written  while 
reputation  and  usefulness  remained  I  but  they  linger 
among  us  only  as  so  many  beacons  to  warn  us  of  the 
fearful  vortex  into  which  this  vice  has  plunged  the 
master-spirits  of  our  age,  once  the  ornaments  of  our 
profession,  and  our  country's  boast.    It  is  enough  to 


APPENDIX. 


105 


cause  a  thrill  of  mortification  and  anguish  through 
our  hearts,  and  a  curse  on  spirituous  liquors  to  burst 
from  our  lips. 

To  those  who  live  by  the  manufacture  or  traffic 
in  spirituous  liquors,  I  would  earnestly  and  affection- 
ately appeal,  as  the  authors  of  a  vast  amount  of  phy- 
sical and  moral  evil,  and  remind  them  that  they  are 
pursuing  a  business  which,  however  profitable  to 
them,  is  death  both  to  the  bodies  and  souls  of  their 
customers.  It  will  be  in  vain  to  attempt  a  defence 
of  their  ill-gotten  gains,  by  the  stale  pretence  that  a 
little  is  necessary,  especially  for  the  sick,  if  I  have  been 
successful  in  showing  that  it  is  worse  than  worth- 
less even  in  medicine.  And  as  this  is  the  last  prop 
on  which  they  lean,  whether  I  have  removed  it  or 
not,  it  must  fall :  for  alcohol  is  as  certainly  destined 
to  be  annihilated,  as  light  and  truth  are  destined 
to  prevail  over  darkness  and  error.  And  in  a  very 
few  years  it  is  now  morally  certain,  that  the  busi- 
ness of  making  and  selling  rum  will  be  pursued,  if 
at  all,  only  by  the  profligate  and  abandoned. 

And  to  my  fellow-countrymen  who  have  unhap- 
pily fallen  into  the  snare  of  alcoholic  medicine,  and 
been  taught  to  believe  that  it  is  harmless  and  useful ; 
let  me  affectionately  remind  such,  that  to  drink  rum 
as  a  medicine  is  as  certain  and  short  a  road  to  drunk- 
enness as  to  take  it  as  a  drink;  as  proven  in  the 
fact,  that  nearly  all  the  intemperance  which  disgraces 
our  country  began  with  taking  a  little,  and  only  as  a 
medicine.  Beware,  then,  how  you  consent  to  enter 
this  gate  of  the  road  to  ruin,  for  even  if  you  find  tem- 
porary relief  when  you  first  begin  the  use  of  tinc- 
14 


106 


APPENDIX. 


tures,  cordials,  elixirs,  or  bitters,  you  will  presently 
discover,  when  too  late,  that  the  medicine  has  pro- 
duced other  symptoms,  more  serious  and  irreparable 
than  those  for  which  you  commenced  taking  it,  and 
a  gnawing  worm  will  be  found  within  you,  whose 
cravings  nothing  but  this  same  medicine  will  satisfy. 
"Better  far  to  bear  the  ills  you  suffer,  than  fly  to 
those  you  know  not  of."  And  if  already  you  have 
begun  to  prove  the  mischiefs  of  alcohol  as  a  medi- 
cine, and  find  within  you  evidence  of  the  mischiefs 
I  have  faintly  described,  abandon  it  at  once,  however 
long  continued  has  been  the  habit,  for  no  mischiefs 
resulting  from  the  sudden  change,  can  equal  the  de- 
struction which  will  assuredly  follow  its  continuance. 

Finally,  what  I  have  written  is  the  result  of  no 
new  and  sudden  impulse,  but  my  opinion  here  ex- 
pressed, is  the  sober  conviction  of  my  best  judgment, 
confirmed  by  close  and  diligent  attention  to  this 
whole  subject,  for  a  number  of  years.  It  is  a  truth 
fully  established  in  my  estimation,  that  alcohol  in 
no  form  is  either  necessary  or  useful  in  medicine ; 
and  my  convictions  that  it  is  invariably  mischievous 
and  often  fatal,  are  so  strong,  that  I  have  thus  ha- 
zarded my  small  share  of  professional  reputation  on 
their  publication.  Of  the  ultimate  result  I  have  no 
fears,  however  severe  the  ordeal  through  which  my 
strictures  may  pass,  or  however  mighty  the  oppo- 
sition which  the  innovation  on  popular  opinion  may 
encounter.  I  therefore  submit  the  whole  to  my  pro- 
fession and  the  public;  and  even  although  I  stood 
alone,  which  is  far  from  being  the  fact,  in  my  opi- 
nions of  the  worthlessness  and  wickedness  of  alcoho- 


APPENDIX. 


107 


lie  medicine,  so  clear  is  my  persuasion  of  duty,  tliat 
I  would  still  hazard  its  performance,  and  cheerfully 
abide  the  issue.  But  I  am  well  fortified  by  the 
knowledge,  that  many  who  have  earned  the  proud 
distinction  of  being  ranked  among  medical  philoso- 
phers, and  among  the  benefactors  of  mankind,  are 
with  me  in  sentiment,  and,  what  is  better,  in  prac- 
tice. With  these  in  such  a  cause,  I  rejoice  to  be 
identified ;  and  if  I  forfeit  the  favour  of  some  of  my  pro- 
fessional brethren,  or  meet  the  frown  of  any  whose 
friendship  I  have  been  taught  to  value ;  I  shall  still 
deem  self  an  insignificant  sacrifice,  in  a  cause  so  im- 
portant to  the  present  and  future  well-being  of  my 
fellow  men,  for,  Homo  sum  ;  humani  nil  a  ine  alie- 
num  jnitoP 

I  cannot,  therefore,  withhold  the  expression  of  the 
opinion,  that  the  true  interests  of  the  public  health 
will  be  every  way  promoted,  by  the  utter  abolition 
of  the  medical  use  of  all  spirituous  liquors,  whether 
externally  or  internally  applied  ;  believing,  as  I  do, 
that  they  are  never  indispensable,  venj  seldom  use- 
ful, and  most  generally  mischievous,  both  in  sickness 
and  in  health.  And  if  this  object  can  be  attained  by 
enlightening  public  opinion  the  manufacture  and 
trafllc  of  the  article  will  cease  to  be  reputable,  and 
none  but  those  who  are  reckless  of  responsibility  for 
the  physical  as  well  as  moral  evils  which  ardent 
spirits  carry  in  their  train,  will  any  longer  sell  or 
use  them.  Then,  and  not  till  then,  will  drunkenness 
cease,  for  while  respectable  men  continue  the  traffic, 
and  are  countenanced  by  the  community,  so  long 
other  respectable  men  will  use  it,  if  not  as  a  drink, 


108 


APPENDIX. 


the3^  will  as  a  Qnedicine,  and  drunkenness  will  thus 
be  perpetuated  to  the  latest  generation.  But  on  the 
contrar}',  if  every  pretext  for  its  utility  and  necessity 
be  swept  away  by  the  power  of  truth,  with  the 
other  ''refuges  of  lies*'  which  have  so  long  deluded  and 
defeated  the  best  hopes  of  humanity  ;  it  will  then  be 
no  longer  reputable  to  live  by  the  gain  made  by  poi- 
soning our  neighbours.  And  so  soon  as  the  traffic  is 
thus  branded  with  infamy,  it  will  become  disgrace- 
ful to  drink  it ;  and  pride,  if  no  better  motive,  will 
put  an  end  to  drunkenness  in  the  nation  and  in  the 
world. 

To  hasten  or  retard  this  consummation,  is  a  respon- 
sibility which  after  all  must  rest  with  our  state  and 
municipal  authorities.  The  distinguished  citizens 
filling  the  high  stations  of  Commissioners  of  Excise, 
Aldermen,  and  other  corporation  offices,  are  by  pub- 
lic sentiment  estimated  as  honourable  men.  And  as 
they  perform  their  functions  under  the  sanctity  of  an 
oath,  if  under  such  circumstances  they  continue  to  li- 
cense indiscriminately,  or  if  they  sacrifice  the  public 
weal,  by  multiplying  the  authority  to  sell,  beyond 
the  real  or  pretended  wants  of  the  people,  as  is  most 
generally  done — it  will  be  impossible  to  bring  into 
disrepute  the  business  which  they  by  their  official 
and  solemn  acts  declare  to  be  reputable ;  nor  can  the 
traffic  or  use  of  ardent  spirits  ever  be  brought  under 
the  ban  of  public  reprobation,  while  they  throw 
about  it  the  protection  of  their  dignified  legislation. 

To  these,  then,  must  the  friends  of  humanity  look 
for  the  exercise  of  their  high  prerogatives,  in  limit- 
ing and  gradually  diminishing  the  number  of  licen- 


APPENDIX. 


109 


ses ;  and  as  they  must  see  clearly  in  the  light  of  facts 
which  are  now  public  property,  that  the  manufac- 
ture and  traffic  of  ardent  spirits  is  an  evil ;  if  they 
will  continue  to  regard  it  as  a  necessary  evil,  they 
should  at  least  aim  to  proportion  the  evil  to  the  ne- 
cessity for  its  existence.  Can  this  necessity  for  licen- 
sing dealers  in  ardent  spirits  be  greater,  now  that 
one  tenth  of  our  population  practise  total  abstinence 
than  it  formerly  was,  when  their  use  was  nearly  uni- 
versal ?  Why  then  are  the  number  of  these  licenses, 
increasing  annually  in  almost  every  place  ?  Is  it 
true  that  the  remaining  nine  tenths  actually  need 
more  facilities  to  procure  this  poison,  than  the  whole 
community  did  before?  Or  is  it  true  that  there  is 
more  rum  now  used  as  a  medicine  than  was  formerly 
consumed  as  a  drink  7  These  are  grave  and  serious 
questions,  which  such  public  functionaries  should 
solve  for  their  own  guidance,  since  on  them  rests  the 
responsibility  of  upholding  or  banishing  intempe- 
rance and  all  its  kindred  evils  from  the  land. 

My  object  has  been  to  show  that  the  sale  and  use 
of  ardent  spirits,  if  a  necessary  evil,  are  not  necessary 
for  medical  purposes.  If  the  evil  is  necessary  at  all 
then,  it  must  be  as  a  drink,  and  who  is  prepared  at 
this  late  period  to  avow  this  opinion,  even  among 
those  who  license  it,  who  make  it,  who  sell  it,  or 
who  drink  it  ?  The  fact  is,  that  rum,  in  no  one  of  its 
forms,  is  necessary,  unless  it  be  to  the  work  of  filling 
alms-houses,  penitentiaries,  state-prisons,  and  grave- 
yards !  If  necessary,  it  must  be  for  that  accursed  reve- 
nue, the  price  of  pauperism,  crime,  and  blood  !  If 
necessary,  I  say  again,  it  must  be  for  filling  the  land 


110 


APPENDIX. 


with  unutterable  wretchedness,  and  peopling  hell 
with  myriads  who  might  else  escape  the  withering 
curse  of  Him  who  has  said,  "No  drunkard  shall  in- 
herit the  kingdom  of  God." 

Away  then  with  this  vile  plea  of  necessity^  as  a 
pretext  for  making  widows  and  orphans  by  thou- 
sands, and  inflicting  upon  thirty  thousand  of  "  our 
fellow  citizens  annually,  the  death  of  a  fool  and  the 
burial  of  an  ass."  And  let  the  public  voice  unite  in 
declaring  by  precept  and  example,  that  all  intoxica- 
ting liquors  are  neither  necessary  nor  useful  "  as  a 
drink  or  as  a  medicine,"  and  are  "henceforth  good  for 
nothing,  but  to  be  cast  out  and  trodden  under  foot 
of  men." 


m 


SEYMOUR  DURST 


FORT   >'EW  A>^STEW5A.^ 


>jewyop.k),  1651. 


ll'ben  you  leave,  please  leave  tbts 

-Because  It  has  been  said 
■'Sver'ihmg  comes  i'  him  who  waMs 

Except  a  loaned  hook. 


hook 


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